Breastfeeding basics: Getting baby to latch properly

Guidance for achieving the proper breastfeeding latch

mother breastfeeding baby

Getting your baby to properly latch is essential for successful breastfeeding, but sometimes that doesn’t happen so naturally. That’s not to say it can’t or won’t happen. With all the support and expertise that is available to help you, breastfeeding is achievable and rewarding for almost all new moms. Knowing that this is the best gift you can give your baby helps make the effort even more worthwhile.

Prior to your baby’s birth, access available resources on breastfeeding. Your provider, hospital and community are resources that offer prenatal breastfeeding classes. At these classes, instructors give comprehensive instruction using videos and/or manikins to show how your baby needs to latch and what you can do to make breastfeeding easier for both of you. Additional valuable prenatal resources are women you know who breastfeed their babies and the La Leche League.

Achieving good lactation

Here are five basic steps that can help your baby achieve good lactation and you find breastfeeding even more enjoyable and rewarding.

1. Figure out in advance the most comfortable position you can remain in for an extended period.
Most women prefer a reclining position. When you lean back, you don’t have to support the baby as much because baby rests on your body. Your baby’s instincts will kick in and baby can latch on with less effort because it’s easier to lift and turn the head and use the hands.

Finding a comfortable position is important because breastfeeding positions that aren’t comfortable can contribute to back pain in new moms. When preparing to breastfeed, remember to have a full water bottle near you so you can stay hydrated. Ask your partner to hold your baby while you get into position. Prop pillows to provide extra support.

How do you find your comfortable position? By experimentation:

  • Cradle: Sit straight up and place your baby in the crook, or elbow area, of the arm on the same side as the breast you are using for feeding. Baby’s body should sit lengthwise across the front of your body. Roll baby’s body toward your body so you are belly-to-belly. Baby’s mouth should be positioned near your feeding breast. Use the opposite hand to support your feeding breast. You should not be able to see baby’s arm that is closest to your body.
  • Cross-cradle: While sitting, support baby’s head with the hand opposite your breast baby is using to feed—left hand for right breast, right hand for left breast. Baby’s mouth should be positioned near your feeding breast. Baby’s body should sit lengthwise across the front of your body angled toward your body so you both are belly-to-belly. As in the cradle hold, you should not be able to see your baby’s arm closest to your body.
  • Football or clutch: Sit straight up and hold your baby at your side face up. Baby’s body will wrap around the outside of your body with baby’s mouth positioned near your feeding breast. Support baby’s body on a pillow. Use your hand on the same side as the feeding breast to support your baby’s head. Tuck baby’s arm under on the same side as the breast being used for feeding. This position is often preferred by women who have had a cesarean delivery because it keeps pressure off your belly.
  • Side-lying using modified cradle: Lie on your side and place your baby next to you with your body and baby’s body facing each other. Try using a pillow under your arm or, if that is uncomfortable, place your baby in the crook of your arm. This position should result in keeping your baby’s head at an angle that easily brings baby and breast together. Baby’s head will be positioned higher than the tummy. This is more helpful for babies who are prone to spit up.
  • Laid-back breastfeeding: Lean back in a recliner or recline in bed. Place your baby on your stomach on top of you. Support the side of your baby’s head if the baby is unable to hold the head up yet.

2. Begin breastfeeding as quickly as possible after the birth.
This makes it more likely that your baby’s innate abilities for latching will kick in and stimulates your milk supply to develop quickly. Baby’s bare skin next to your bare skin also stimulates those reflexes. You may be surprised with how quickly your baby starts rooting and looking for that nipple. Keep these tips in mind:

  • Holding your baby skin-to-skin on your chest as much as possible, even when not breastfeeding, will help you become more familiar with your baby’s feeding cues.
  • Uncover your baby and your chest as much as possible during breastfeeding. Babies that are dressed too warm are more likely to doze during feedings. If you feel chilled or are concerned your baby might get chilled, put a light blanket loosely over both of you.

3. Encourage your baby to nurse.
Watch for your baby’s signs or cues that it’s feeding time and put the baby to your breast when baby cues. Don’t wait for the baby to cry. Crying is one of the last feeding cues. Generally, the baby latches and breastfeeds better if feeding takes place before the baby begins crying and is frustrated. Trying to get your baby to wait longer between feedings by offering a pacifier instead of the breast is not advisable. Let your baby determine feeding times. Because skin-to-skin contact encourages reflexes, place baby on your body so baby’s cheek and chin touches your breasts.

  • Babies should wake and cue to breastfeed about eight to 12 times in 24 hours. Cues include rooting, licking or sucking motions, bobbing the head or bringing a hand to the face or mouth.
  • If your baby is a sleepy baby who does not cue to feed at least eight times in 24 hours, wake the baby to feed more frequently. Strive for every two hours during the day and at least every three to four hours during the night.
  • If your baby falls asleep within minutes of latching on, massage your breast as baby nurses. Stroke downward and inward on the breast, which will provide a flush of milk that will likely reinvigorate baby’s sucking.

4. Help your baby to latch properly
Support your breast from underneath with your hand. Your baby’s bottom lip should be at the base of your areola and the nose opposite your nipple. When done correctly, baby should have a big mouthful of your breast, including both nipple and areola. The chin and nose should be touching your breast, and your baby’s lips should be flanged outward like a trumpet or fish lips. Rub or gently squeeze your nipple to compress the areola and make a little milk come out. Your baby will smell it and latch on. Here are some suggestions for helping your baby latch:

  • You can try a C-hold, the term used for putting your thumb on top of the breast and your fingers underneath your breast, creating a “C” shape. Fingers should be placed approximately 1-1/2 to 2 inches behind the nipple. This works well with the cradle or cross-cradle positions.
  • A U-hold is the term used for positioning your hand with your thumb on one side of the breast and your fingers on the other, creating a “U” shape. This is often used when a baby is placed in the football position.
  • You may not have to continue to use a C-hold or U-hold after baby begins breastfeeding if your breasts are smaller, but mothers with larger breasts often maintain the hold throughout feeding.
  • If baby isn’t showing interest in latching, use your nipple to stroke the baby from the nose to the lower lip in a downward motion. Wait for baby’s mouth to open. Then, quickly bring baby and your breast together.
  • When baby is latched, the lips should not be pursed or rolled in. If you were to roll down your baby’s lower lip, you should see baby’s tongue gliding in front of the lower gum. You should be able to feel baby’s tongue cupping your nipple.
  • Do not press down near the areola with your thumb. Some mothers do this thinking baby’s face looks so buried in their skin that doing this will help the baby breathe better. However, it will pull your nipple from the back of your baby’s mouth and that is where it should be.
  • Babies’ noses are flatter at birth and in early months because this allows them to latch on and still breathe. If you really are concerned about your baby’s breathing, pull the baby’s lower body closer to you or lift your breast rather than pressing downward on it.

5. Learn how to identify a good latch.
If you feel a pulling sensation on your breast, that’s a good sign. Check to see if your baby’s lips are around the nipple and areola. If they are not fully around the area, you are likely to get sore nipples, and your baby is not getting a good feeding. Also, check if your baby is getting milk. Look at baby’s temple and lower jaw. If both are moving consistently and you occasionally hear a small gasp or noise from baby, that means baby is drinking and exhaling. In the beginning when your milk hasn’t come in yet, this won’t be as obvious because colostrum isn’t as abundant and does not flow as easily as milk.

Keep this information in mind to ensure baby is latching correctly and gaining appropriate weight:

  • If your baby’s latch is shallow, feedings will take much longer with your baby getting less milk. Your nipples will get sore and can become cracked and painful. This will make it more difficult for baby and you to enjoy feeding time. If you can tell that the latch isn’t good, pull baby from the breast and try again. Try the various positions to achieve a better latch.
  • In general, avoid switching breasts every few minutes, particularly, if your baby has trouble getting a good latch. Switching back and forth may interfere with your baby getting enough of the calorie-rich hindmilk, which your baby gets more of as a feeding continues on one breast. Please note that some providers recommend switching breasts frequently if your baby continually falls asleep during feedings.

As you become more comfortable breast-feeding, you will likely be able to tell if baby is getting sufficient milk just by the levels of tugging you feel.

Getting Assistance

Having sore or tender breasts is common in early weeks of breastfeeding; however, you shouldn’t feel pain or discomfort all the way through a feeding. If that’s the case, something isn’t working correctly. Additionally, if your baby is not gaining weight adequately, a poor latch may be the cause.

When difficulty with latching or sucking persists beyond the first several days after birth, it can be discouraging. Most babies do learn to breastfeed effectively—some learn a little more slowly than others! Until the issue resolves, there are several things you can do to help breastfeeding progress to make sure your baby is getting enough to eat.

Talk to your health care provider and a certified lactation consultant if you are having difficulty. Lactation consultants are experts who can easily identify positioning and other factors that may be impacting feedings. They can also help with special feeding strategies when your baby has a physical impediment that makes breastfeeding more difficult. And they can assist you with alternative feeding methods, if advisable. Best of all, they are a source of knowledge and comfort that will help you and your baby achieve success!

Posted In Children's, Health Information, Women's

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