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When baby won’t latch (newborn + older baby)

When baby won’t latch (newborn + older baby)

by Wendy Wright

A year ago


One of the first things you learn about breastfeeding is that latching well is essential to transferring milk. Many problems – from sore nipples to slow weight gain – can be resolved with simple changes to baby’s latch. But what if your baby just won’t latch at all? Wanting to breastfeed but not being able to get baby to cooperate can be one of the scariest problems for new moms.

Your baby needs to eat – so that’s your first priority. Whether it’s expressed breastmilk or formula, your baby needs calories while you work on getting him to latch. Your second priority is keeping up your milk supply. Milk removal is the key for milk production. If baby’s not nursing, you will need to pump as often as baby is feeding. Finally, you can work on getting baby to the breast.

Start by assessing the situation to find a root cause:

  • Did you have pain medications for labor? A sleepy baby may just not be able to latch. Given time and access, your baby should start nursing once the medications are metabolized out of his system. In the meantime, hand express colostrum and feed this to baby by spoon or syringe and spend lots of time skin to skin.
  • Do you need to support your breast better? If you have larger breasts and they are heavy because your milk supply is increasing, the weight may be too much for baby to handle with his jaw muscles. Supporting the breast underneath with your fingers or a rolled towel might help. Techniques like a ‘breast sandwich’ and the ‘nipple flip’ are sometimes advantageous when you have larger breasts.
  • Are you too engorged? When your milk comes in a few days after birth, your breasts may become hard and distended, and your baby may just not be able to grasp the tissue. Frequent feeding and time are the keys to resolving engorgement, but techniques like reverse pressure softening, moist heat and hand expression may help, too.
  • Do you need to change baby’s position? Perhaps your baby is uncomfortable in the cradle hold, but will do better in a football hold. Experiment to find what works best for your baby.
  • Are you touching the back of your baby’s head? While you need to support baby’s neck, if your fingers or palm are on the back of his head, your baby may react by pushing backward toward your hand rather than moving forward toward the breast (probably as an instinctive effort to protect his airway).
  • Does your baby have anything physically wrong, such as torticollis, cleft palate, or tongue-tie? Work with your baby’s pediatrician to rule out any physical anomalies that may impact feeding.
  • Is it nipple confusion? If your baby has had many bottles, he may start to prefer the solid feel to that of the softer breast tissue that needs to be shaped into a teat.
  • Does your baby have thrush? A sore mouth may cause baby to resist latching and feeding.
  • Do you have overactive letdown or oversupply? A baby quickly learns when he’s going to be overwhelmed by the flow of milk, and he may simply resist latching.
  • Is baby teething? Again, a sore mouth can cause feeding problems. You’re your older baby is teething, you can use a topical analgesic, or allow baby to chew something cold right before nursing.
  • Does baby have a cold? If baby can’t breathe through his nose, he may not be able to suck-swallow-breathe adequately and will simply refuse to latch. Ask your baby’s doctor about the best way to treat cold symptoms. Sometimes saline nose drops and an aspirator are the easiest solution.
While you’re working to resolve whatever issues you’ve discovered, spending time skin to skin is useful. Carrying baby in a sling or wrap, co-bathing, and dream feeding (putting baby to the breast before he’s really awake), may all help.

 

The most important tip we can provide is to get the help of someone knowledgeable about breastfeeding – preferably a board-certified lactation consultant (IBCLC). These professionals will be able to help you troubleshoot and find solutions that will work for you and your individual baby.

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