A good latch is essential to your baby getting enough milk. A poor latch can not only be painful for mom, but can also keep baby from removing enough milk leading to slow weight gain and low milk supply.
When your baby is latched to the breast well, you should notice the corner of his mouth is wide (has an angle greater than 90 degrees) and he has lots of breast tissue in his mouth. If it looks like his lips are puckered (like he’s kissing the breast), then the latch is too shallow. He can have his chin buried in the breast and his nose touching it. When he nurses, you will notice some quick sucks followed by longer sucks with swallows as your milk lets down. He may pause now and then, but should be having bursts of swallowing throughout a feeding. Swallows may also sound like a soft ‘kah’ sound. His cheeks should be full, not sucked in.
The best latch is an asymmetric one. With an asymmetric latch, baby has more of the lower areola in his mouth than the areola above the nipple. To achieve this when latching, start with your nipple next to baby’s nose. When he opens wide, your nipple should point to the roof of his mouth. His lower jaw will touch the breast first, with his upper jaw closing over the nipple before he begins sucking.
If your breasts are large, or if they’re just heavy because they’re full of milk, you may need to support them throughout a feeding. You can do so with your fingers or with a rolled towel – just make sure they’re far enough back that they don’t interfere with baby’s latch. Without the support under the breast, gravity may keep pulling the nipple out of baby’s mouth, changing the way he’s latched. In addition to the discomfort it will cause you, it may fatigue baby’s jaw and keep him from being able to suckle correctly.
Sometimes baby needs a little help with latching. The following techniques can help with latching:
- Breast Sandwich: Imagine yourself taking a bite of a large burger with lots of toppings. What do you do to get your mouth around it? You smoosh it down. You can do the same with your breast to help baby get ahold of it. Flatten your breast so that it aligns with the direction of baby’s mouth, bring him to the breast, let him latch, then let go of the sandwich so he can suck.
- Nipple Flip: This trick sometimes helps you get a good asymmetric latch. With your thumb, press into your breast on the areola above the nipple when the nipple is opposite baby’s nose. When baby opens wide bring him to the breast. As soon as his lower jaw touches you, release your hold and use your thumb to flip the nipple into his mouth.
- Reverse Pressure Softening: If latching is difficult because your breasts are engorged, softening the areola can help the baby attach correctly. To use reverse pressure softening, you simply press two fingers and hold at a variety of positions around the areola. You can find instructions here. Alternatively, you can use a breast pump or hand expression to soften the areola and get milk flowing before trying to latch your baby to the breast.
If your baby still has trouble latching, something may be wrong with baby’s oral anatomy. Working with your baby’s doctor and a lactation consultant can help you determine if perhaps tongue-tie, torticollis or another health issue might be causing the problems with latching. In addition, a lactation consultant can help you determine the best course of action when baby has latching difficulty. Sometimes, a nipple shield is a good tool for getting baby to the breast. For other babies, laid-back positioning with self-attachment is useful. Working with a knowledgeable lactation professional can make a huge difference in getting a good latch if you’re struggling to make it work.