The Right Latch Makes All the Difference
By Teri Brown
Often those things in life you thought would be simple turn out to be not so simple. Take breastfeeding, for example. For most women, it’s a simple question of Baby meets nipple, and that’s the end of it. For others, it’s not so easy.
Mary Hake, mother of two from Crooked River Ranch, Ore., is one of those women. Her first daughter was born four weeks early and weighed less than 6 pounds. She had breathing difficulties and developed jaundice, so for several days, Mary wasn’t allowed to hold her. “I pumped my breasts to get milk and finally was able to begin nursing her,” says Hake. “She was sleepy and ate every few hours. She seemed to have trouble grasping the nipple in her tiny mouth.”
Latching on is the process of the baby’s mouth connecting to the mother’s breast.
The nurses at the hospital weren’t particularly sympathetic, and it wasn’t until Hake was able to contact the La Leche League and attend regular meetings that she realized it was a latching problem. With their advice she was finally able to solve the problem and go on to a successful nursing experience. “Their advice and encouragement really made a difference,” says Hake.
The Key to Success
Latching on is the process of the baby’s mouth connecting to the mother’s breast. With a proper latch onto the breast, the baby is able to bring forth the proper amount of nutrition. When there isn’t a proper latch, you have a frustrated, hungry baby and a frantic mother. When there is a proper latch the following occurs:
- Baby’s mouth should be open wide.
- The tongue should be down, cupping the areola.
- The lips should be flanged.
- There should be rhythmical sucking.
Bonnie Henson is the clinical operations manager of lactation support services for Miller Children’s Hospital in Long Beach, Calif. She believes that many times latching problems are simply due to the mother and infant needing time to work together to get it right. “The baby needs quiet time with the mom directly after delivery to explore and become accustomed to the new surroundings,” she says. “This can be best done if the baby is placed skin to skin with mother with the baby wearing only a diaper. Occasionally, there may be difficulties caused by Mother or Baby anatomy (e.g. inverted nipples, breast surgery, cleft lip, tongue tie), but with the assistance of a lactation expert, such as an international board certified lactation consultant (IBCLC), these issues can be addressed and usually overcome.”
Step by Step
Henson says that education is the best way to prepare for latch on before Baby comes. Reading up on the topic is very helpful. “Practicing using a doll may be helpful, but that is much like trying to learn to ride a bike without a bike,” she says. Instead, Henson suggests the following step by step guide to help mothers and infants obtain a proper latch on:
- Latching a baby on should begin with the mother in a comfortable position.
- Use pillows as needed to support your back and arms and to bring the baby to breast height.
- Position Baby with his body facing you (chest-to-chest) at breast level. Baby’s ear, shoulder and hip should be in a straight line.
- Support your breast with your hand in a “C” shape with the thumb and forefinger well away from the areola (dark part of your breast).
- Tickle the baby’s lips until the baby opens her mouth wide, and then pull Baby (chin first) toward the breast, allowing the baby to take about one to one and a half inches of breast tissue into her mouth.
- Check to be sure the lips are flanged out and Baby is rhythmically sucking and swallowing.
- If uncomfortable, then unlatch the baby by inserting your finger in the baby’s mouth, gently pushing down on the jaw to release the suction and remove the baby. Repeat the process until comfortable.
“This is a very basic guide to latching on,” says Henson. “Further instruction can be obtained from many good books, such as The Womanly Art of Breastfeeding (Plume, 2004) by La Leche League International or Nursing Mother’s Companion (Harvard Common Press, 2005) by Kathleen Huggins, and may be purchased at most bookstores.”
More to Know
According to Henson, a common sign of an incorrect latch would be a painful, pinching sensation with the latch that does not resolve in the first few seconds of the latch. “When Baby is removed from the breast, the nipple will often be pinched or creased or may have the look of a new tube of lipstick, flat on the bottom and pointed at the top,” says Henson. “Most infants who have not latched on correctly will seem to be hungry very frequently around-the-clock, and have a decreased diaper count. This is due to a poor milk flow and decreased intake of milk.”
Diane Spatz is the clinical nurse specialist in lactation at the Children’s Hospital of Philadelphia. She agrees that Mom will be the first to know if the latch isn’t correct. “If the infant is not correctly latched on to the breast, the infant will not receive adequate milk transfer or give the breast adequate stimulation, and breastfeeding will be painful!” she says. “The infant should never be suckling on just the nipple.”
Spatz says another important step to a successful latch is knowing your infant’s hunger cues. “Crying is a very late hunger sign,” she says. “Feeding cues are the infant bringing hands to mouth, sucking on their tongue, making grunting noises and rooting.” Remember, it is much easier to get the proper latch on a baby before his hunger becomes out of control.
Latching on is a simple, but oh so important, process. New mothers who are having difficulties getting their infants to latch on should look to knowledgeable hospital nurses for assistance and request help from a certified lactation consultation (IBCLC or CLE). After discharge from the hospital, Mom can seek help from one of the following sources:
- An IBCLC in the community
- LaLeche League International
- The local WIC program (Check the telephone directory)
- Community Mother/Baby support groups
- BIH (Black Infant Health), which is usually a part of the local health department