The Importance of Latch

The Importance of Latch

Latch is one of the trickiest things to work with in the early days of breastfeeding. It’s quite difficult to know what you’re looking for when both you and your baby are new to this! It honestly just takes some time to get the hang of it; watching how it looks in combination with how it feels will let you know whether you’re on the right track. 

There are a few tips we can offer to help. Part I has to do with your physical set up. You want to make sure that you and your baby are comfortable and well-supported! Remember the mantra: Adjust your body, Adjust the baby, Adjust your breast - in that order!

First step: Adjust your body!

Regardless of where you are sitting (and you can make this work anywhere you feel best), your back should be well supported. Roll your shoulders back to remind yourself to have good posture. Add in as many pillows as you need to support your back, elbows and arms. You should be completely comfortable where you are sitting before we add the baby!

Next step: Adjust the baby! 

Bring the baby to YOU, not you down to the baby. This is usually best facilitated by having a nursing pillow, or another soft pillow, to lay the baby on to bring them up to your chest level where they are at the right height to reach your breast so that you do not start to lean too far forward. (Otherwise this will eventually create very sore shoulder muscles!) Babies really like to have positional stability to feel secure while they are nursing, so they want to be lying on a surface (a pillow, mattress, your body), with that full body contact, tummy to tummy, and a nice firm pressure of your other hand on their back or upper shoulders.

Last step: Adjust your breast!

You can think of holding your breast tissues like a sandwich! Use your free hand to hold it like a hamburger for the baby - lower portion into the mouth first and then you sort of flip the rest in. However you conceptualize it, once you have your body positioned comfortably and your baby raised right up to chest height, staring nose-to-nipple, you use your hand to shape/support/guide the breast as needed to help them latch on. 

Then, once your baby is latched and happily drinking, settle your body back like you’re watching TV. Your support person can bring you extra pillows to prop under your arms that are holding the baby, or prop up your head or back. You may want lots of pillows around in the early days to make this more comfortable - that won’t always be the case, but in the first few weeks it can be very useful while you are learning and your body is healing.

Part II in Latch Tips are what to look for in a good latch, and what we should be looking to avoid in a poor latch.

What are some clues to look for in a good latch? They are small but important:

• You may initially experience some intense discomfort at the beginning of a feeding in the early days, but it does not last for the duration of the feeding. 

• You and the baby are tummy-to-tummy

• Your baby’s head is turned straight towards the breast

• Your baby’s chin touches the breast

• Your baby’s nose is pressed against the breast

• Your baby’s mouth is open as wide as they can possibly make it (about 140 degrees), around the whole areola, not just the nipple

• Your baby’s lips are flanged out

• You can hear or see swallowing

• Your baby’s ears move slightly

When the latch is wrong, you can tell immediately. There is a pinching or painful feeling that does not go away after the initial latch.

Other signs of a poor latch include: 

• Only the tip of the nipple is in the baby’s mouth

• Your baby’s lips are flat or curled in

• Your baby’s face is not touching the breast

• Your baby’s belly is facing up

• Your baby keeps breaking suction and coming on and off the nipple

• The nipple is in the shape of a new tube of lipstick when it is removed (angled/misshapen)

• Nipples are very red, skin is broken, bleeding or scabbing

If you are feeling this, you need to unlatch the baby immediately and restart. DO NOT continue to feed the baby with a bad latch! It will damage your nipples and the baby will not learn the correct way to feed. To unlatch a baby, slip your finger between the baby’s gums so that they open their mouth and release the nipple; never pull a nipple out of a closed mouth, which will hurt the nipple. You can try again immediately. Oftentimes, people are very worried about upsetting the baby by taking them off; but babies are actually not too upset by this for long, as they are anxious to get back to the milk! It is much better to teach babies the right way to nurse, and that way, they should actually get a stronger, more satisfying stream of milk. If they go right back on to the breast and get back to their meal, they aren’t usually crying any longer. So be brave and stand up for yourself! Your pain matters; you are not called to sacrifice your body in the name of a bad latch.

One of the reasons this is so important is because if nipples become damaged, it is difficult for them to heal. An open wound that is being sucked vigorously 10-12 times a day is uncomfortable to say the very least; it is sometimes painful enough to lead a person to stop breastfeeding completely. It is worth going to great lengths to avoid the primary damage. Ask questions of hospital staff, your doulas, your pediatrician, lactation consultants. A nipple shield can be used with the advice of one of your providers to halt the damage and preserve breastfeeding while you work to determine the underlying issues. 

One way to differentiate between discomfort and pain is to count to ten when the baby latches and starts sucking. If the discomfort or pain subsides after ten or so seconds, your body is adjusting to the new sensations. If, after ten seconds, the pain continues about the same level and does not improve throughout the feeding, something is wrong with the latch, and the baby needs to be unlatched and restarted. 

A few final pro-tips for making slight adjustments once you already have baby on, or if you’re still feeling that things are not quite right with the latch:

• Make sure that the baby’s nose is pointing to your nipple before the latch - this means the baby’s head should be very slightly reaching up towards the nipple, never down towards it.

• Make sure that the baby’s head has room to move so they do not feel trapped - we want them to be able to tilt their head back before they latch, as we do to drink. They often move their head back right before their widest gape, so be watching for that!

• Sometimes a firmer pressure on their back, pressing them in towards you, will arch their back and open their mouth a bit more.

Finally, remember to reach out for help if this topic remains confusing, if you and your baby are struggling to figure it out, and most definitely if you are in pain! Breastfeeding is not supposed to hurt. We absolutely do not accept that pain is the entry cost parents pay to feed their babies with their bodies.

~ Naomi, Infant Feeding Expert*

*If you need help to schedule your bundled Infant Feeding session with Naomi…email Elizabeth Parish.