Achieving a Comfortable Latch!

You’ve read the books, watched the videos and taken the classes – you’re ready! Or maybe you didn’t but either way your baby has arrived and now it is time for baby to latch and feed. Perhaps you settle your baby between your breasts and after a few moments they start to bop their head, weaving and wiggling down towards your nipple. They may lap and nuzzle until they find the right spot, latch and feed. This is what we envision when we think about “naturally” feeding our baby. Sometimes this happens but sometimes it doesn’t. What then?

I will try and emphasize that there is no one right way to latch your baby. Positions can be different, technique can be different but there are some important clues that we have achieved an effective latch. Important point number one. If it hurts – something off is happening. The slightest pinch that eases almost at once I can live with but beyond that – no thanks. Point number two that we are watching for is active sucking and swallowing. We can get into that a little later.

So, if what we are doing isn’t working, what can we do and try to improve things? Here are some tips and strategies to help achieve a comfortable latch!

1.      Ensure your baby is lying tummy to tummy with you. This means that they aren’t rolled away from you and twisted. It also means that they aren’t rolled facing downward. Both positions can make latching and drinking more challenging. We can see if they are lined ideally by seeing their ears, shoulders and hips in a straight line.

Note ears, shoulders and hips are in a line.

2.      You want to line babe up with your nipple at their nose level. You may also want to have your babe’s chin resting on your breast. This can help orient them to your breast. It isn’t uncommon to see babies vigorously shaking their head from side to side. They are seeking and searching and often get frustrated because they don’t know where the breast is. When we think of latching a baby, we think like a bottle nipple and right into the mouth it goes. When we understand the mechanics of latching a baby onto the breast, we realize that the bottom jaw stays more steady and it is actually the upper jaw that lifts up and over the areola. This mechanic is similar to us biting into a large sandwich.  

Ideally this baby would have their chin also resting on the breast in the “sniffing” position.

Note this baby is not lined up nipple to nose. Latching would be easier if this baby was scooted down at least an inch so that his bottom lip lined up with the bottom of the areola near the red line.

3.      We like to encourage breast shaping with your free hand. This can compress the shape of the areola and make it smaller to better assist with latching. Similar to how one squishes down their sandwich before taking a bite. We do this by lining up your thumb horizontally to your babe’s nose like a moustache and then you wrap the rest of your fingers around the breast to rest near your babe's chin. We want to make sure that the fingers are away from the areola. With compression we want to see that areola "wrinkle" and get smaller. With babe's chin resting on the breast, we wait for that wide open gape and then bring baby in deeply and quickly. Take note that I didn’t emphasize which position you or baby must be in. Remember your baby is breast feeding, not nipple feeding. It is important that they take in your areola breast tissue. For example, this strategy works if you are holding baby in cross cradle or football etc. It is possible we need to keep that breast shaping to make sure a comfortable latch is maintained. This is especially likely in the early days of feeding when you both are still practicing and strengthening your skills.

Note minimal breast/areola shaping. This is a top down visual

Note breast/areola shaping. Wrinkling of the areola is seen.

4.      If the latch feels comfortable and baby has a wide-open latch (corner of the mouth is about 140 degrees) and the bottom lip is flanged/the chin is so buried you can't see it - we are happy. Depending on the size of your areola, we are looking for all of the bottom (by babe's chin) and as much of the top (by babe's nose) in their mouth as possible. This is what we call an asymmetrical latch. It allows for your baby to suck and draw in your nipple to reach the junction between their hard and soft palate. *Don’t know where that is?* Roll your tongue from the front of your teeth, all the way back towards your throat. You should feel the ridge of this junction. When babe has a shallower latch – we are feeling the breast not as deep into the mouth and when they suck, they are compressing the breast and nipple against that hard palate. That repeated compression is what leads to pain and trauma.  If it is feeling okay but maybe could be better, you can either tug down gently on their chin or tuck their bum in closer to your body without twisting your own shoulders. You can do both. You can also put your feet up and lean back until your comfortable - bringing baby with you.

5.      Another point to remember is you are bringing baby quickly and firmly into you. You may be surprised if you have a lactation consultation at the swift latch on movement. Sometimes that wide open mouth is only a quick short moment and we want to take advantage. Think of the game “whack a mole”. You are watching for your timing and must be quick or the moment has passed. What you don’t want to be doing is following your baby around with your breast or leaning over onto them. This can make latching more challenging and feeding your baby more taxing on your neck, back and shoulders. The goal is that you and your baby are comfortable to sit and feed.

6.      I mentioned active sucking and swallowing. This is something we watch for to ensure that your well latched baby isn’t spending all of their time casually sucking and hardly drinking. Most often the first minutes of latching include some “non-nutritive sucking”. This is when they are initiating a larger let down of milk. How they do this is what I refer to as butterfly sucking. The lower jaw moves in quick flutter like motions. Once a let down is triggered we witness a change in this pattern to slower, deeper, more rhythmic motions. We call this “nutritive sucking”. Both patterns have a purpose when in balance. We may hear the gulp of a swallow of milk or we may observe the quick scoop up of the tissue between the chin and the throat. We often will see a series of these sucks and swallows followed by a pause for breathing. Then we see the rhythmic sucking and swallow begin again. After a few sets of this pattern, we may notice a shift back again to the butterfly flutters which are trying to trigger a second let-down.

First Latch

Note wide open gape. This could be easier for baby if her chin was buried into the breast. You can see that her chin is angling down towards her chest.

Is this how you have to latch your baby? No. Can some of these strategies making latching and feeding easier, maybe! If they don’t and you are still struggling such as painful latching or your baby won’t stay latched, it is time to seek help. That would be the time to get a consultation with an International Board Certified Lactation Consultant. They can usually decipher the intricacies of your journey and make suggestions to help you out.

Natalie - Dated: Oct. 27, 2021