Breastfeeding positioning and latching
Latching problems can interfere with the amount of milk baby gets in (milk transfer) and it can cause Mom bad nipple pain.
Main causes of latching problems:
• Poor latching technique.
• Baby does not open his/her mouth wide enough.
• Nipple confusion due to the use of pacifiers or artificial nipples.
• Baby was/is exposed to drugs during pregnancy / during labour
and/or while breastfeeding.
• A floppy or low muscle tone baby.
• Baby and mother where separated after birth.
• Not letting baby feed on demand.
• Baby is small for gestational age.
• Baby has neurological problems.
• A high arched palate.
• Baby is premature.
• Poor latching due to a receding jaw.
• Baby was injured during birth.
• Oral aversion caused by extreme suctioning or gavage feeding.
Signs and symptoms of latching issues:
• Baby’s mouth is at an angle of less than 160° when breastfeeding.
• Baby’s cheeks are dimpled.
• There are clicking sounds while baby is breastfeeding
• The breast keeps slipping out of baby’s mouth.
• Mom has pain in the areolae area as well as nipple pain.
• Mom and baby should be positioned tummy to tummy (skin on skin is always best.)
• Baby should not have to extend or arch his back. Baby’s shoulders and hips should be aligned.
• Mom should make sure that baby’s mouth is open wide before trying to latch baby onto the breast.
• Baby’s lips should be turned out, not sucked into the mouth while feeding.
• Baby should take in some of the areola as well, especially at the bottom lip.
• Mom can hold her breast for support and compress it to help baby latch on.
• Mom can brush baby’s lips with her nipple, to encourage him/her to open their mouth.
• If baby has tongue problems, you can read more tips here.
• If Mom has inverted or flat nipples, read more on how to cope with this here.
• A nipple shield can be used as a last resort to try and shape the nipple, allowing baby to latch on more easily.
If baby is not drinking enough during feedings, Mom can pump
in-between feeding to increase milk supply. Mom can give the supplements
of breast milk to baby with a SNS (supplementary nursing system)
Bottle containing pumped milk is attached to the breast with a little
tube running into the side of baby’s mouth, while baby is breastfeeding.
This will help baby learn to breastfeed while being supplemented with
Moms milk/donated milk or formula.
• If baby has other sucking problems such as tongue tie or tongue thrust, read more here on how to cope with this.
Preventing newborn latching problems
• Avoid unnecessary birth intervention such as elective C-sections, suctioning, medication or separation of Mom and baby.
• Avoid giving baby a pacifier or artificial nipple before 6 weeks of age.
Tracy Behr, CBC, CLD (CBI)
Reference: Course information through child birth international on physiology of breastfeeding / breastfeeding problems / latching problems.
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