Long before books and the Internet, women were breastfeeding their babies. How on earth did they manage without all the instructions about asymmetrical latch, C-hold, cross cradle and football holds and wide gape?! They managed because back then, breastfeeding was the norm, and you learned to breastfeed by watching your mother, sisters, aunts and friends breastfeed. It wasn’t the mystery that it often seems to be today when many women have never even held a newborn baby before their own, let alone seen someone breastfeed. We are meant to learn about breastfeeding by watching others, not by reading about it in books or on-line. In today’s society however, the art of breastfeeding has been lost, and instructions have become necessary.
Traditional latching instructions usually include advice to use a “C” or “U” hold on your breast, to tickle your baby’s lips with your nipple, wait for him to open wide and quickly pull baby closer. Then you’re supposed to look for “fish lips” and a certain amount of areola showing above baby’s top lip, etc. In recent years, a lot has been written about the importance of an “asymmetric latch” and there are lots of available descriptions about the various holds that you can use with your baby. Often, the “instructions” for getting a good latch are confusing, hard to visualize, and cause parents to stress about “getting it right.” New research, however, has recently lent insight into the process of “latching on.” This new research has changed the way that many breastfeeding professionals talk to parents about latching.
The most important thing to come out of the latest research, is the confirmation that babies know what they’re doing! The most profound example of this, is the fact that an unmedicated baby placed on his mother’s abdomen after birth is capable of finding her breast, and latching on, just like any other mammal (often referred to as breast crawl). Babies are born with instincts and reflexes that help them to find their mother’s breast and figure out what to do once they get there. Suzanne Colson’s recent work on biological nurturing teaches us about how positioning can make a big difference to breastfeeding success, and that a baby’s reflexes can work for or against breastfeeding, depending on the position that the baby is being held in. Biological nurturing involves having mom in a semi-reclined position, and letting baby lead the way with latching while mom helps as needed. The reclined positioning is important because it releases reflexes that help baby to find mom’s breast and latch on.
There is also some important new research from Catherine Watson Genna about how babies use their hands to help with latching on. Her research brings to light the fact that those little hands that keep getting in the way when you’re trying to bring your baby to your breast, are actually making purposeful movements trying to help with latching! For years we’ve been advising mothers to tuck those little hands out of the way, and now we’re discovering that it’s important for babies to have their hands free. If your baby’s hands are in the way, it is probably because he can’t feel your breast with his face, so he is searching with his hands for your nipple. Cuddle your baby closer so that his face is against your breast, and those little hands will likely move out of the way.
Some women seem to find the reclined positioning of biological nurturing awkward at first, perhaps because it is not what we are used to seeing. We are far more familiar with upright positioning for nursing, and many new moms are more comfortable with this when learning to latch. If the upright positioning is more comfortable for you, then you can use what some in the lactation community call “baby led, mother sped” latching, where mom places baby at the breast in the right position to latch on. Once your baby is latched on, you can then lay back into a more reclined position if it is comfortable for you.
Main points to remember for “baby led, mother sped” latching:
- Sit back and relax. Many new moms have a tendency to sit forward and lean over their baby. Make yourself comfortable and bring your baby to you. If need be, focus on keeping your back against whatever you’re sitting on. It is preferable if you’re not in a straight backed chair. Being able to lean back a bit helps your baby latch on.
- Your baby’s whole body should be turned towards you, so that your baby is not having to turn his head to find the breast. One thing that I often see is baby’s head and chest are turned towards mom, but baby’s hips aren’t, which tends to pull baby away from the breast. If your baby’s body is turned completely towards you (so the two of you are tummy to tummy), and you are sitting back, then gravity helps to keep your baby in place. In this position, your baby feels secure, and it helps to release those newborn reflexes that help with breastfeeding.
- Snuggle your baby at the height of your breast, where it naturally lies. For many moms, this means get rid of the nursing pillow! Pillows work for some women, but certainly not all. Often, the pillow puts your baby above the height of your breast, and you end up having to lift your breast to reach your baby. The problem with this is that when you let go of your breast, gravity pulls it out of baby’s mouth. Supporting your breast with your hand is fine, but if adjustments need to be made, move your baby not your breast. If you’re sitting back in a slightly reclined position so that gravity can help to keep your baby in place, a pillow really isn’t necessary.
- Pay attention to where your hands are. The hand supporting your baby’s head should not be on the back of baby’s head (this triggers a reflex in babies that causes them to push back against your hand, and away from your breast. Some babies are sensitive enough that even a finger up the back of their head will trigger this). If you are supporting your baby’s head with your hand, place your hand around the base of your baby’s skull, with your fingers just below baby’s ears. If you are supporting your breast with your other hand, make sure that your fingers are well back from the areola so that they are not in the way of your baby latching on.
- It’s important to remember that your baby finds your breast mainly by feel. Your baby needs to be able to feel your breast with his chin/cheeks in order to figure out where he is. This means that your baby needs to be snuggled in nice and close, with his chin already touching your breast before he latches on. The ideal position for your baby to be in is with his nose opposite your nipple. This allows your baby’s head to tip back slightly, and it places your baby in the best position to get a comfortable latch. If need be, shift your baby’s body towards the opposite breast to get your baby in the right position. When your baby feels your breast with his face, it triggers him to open wide. When he does, all you need to do is snuggle him closer using the hand that is supporting his neck and shoulders. If need be, you can use the thumb of your other hand on top of your breast to help guide your nipple under his top lip. Tickling your baby’s lips with your nipple puts your baby in the wrong position for getting a good latch and confuses your baby because he can’t feel your breast with his face. This usually causes a baby to shake their head back and forth as they search for the breast.
- Once your baby is latched on, you can use pillows, folded blankets etc to support your arms or hands as necessary for comfort.
This may seem like just another big list of latching instructions, but really most of it is reminders about positioning. This is because positioning makes a big difference when it comes to getting a good latch. Here’s the short version:
- Sit back and relax
- Bring baby to you with baby’s whole body turned towards yours
- Chin to breast, nose to nipple and snuggle your baby closer when he opens wide
Notice that there are no instructions about how to hold your breast, what baby’s lips should look like, how much areola you should see etc. That’s because for most women those things don’t matter. If you need to support your breast, hold it however it is comfortable for you. As for what the latch looks like, what is far more important is how it feels. If your baby’s latch feels comfortable and your baby is getting enough milk, then everything is good no matter what it looks like! Some latches don’t look “right” from the outside, but if it’s working for mom and baby, no need to mess with it. Some latches can look great from the outside, but if mom is in pain, something is wrong. When your baby is latched correctly there should be no pain, and after nursing your nipple should look the same as it did before nursing. If your nipple appears pinched or flattened after feeding, this is a sign that either your baby’s latch still needs some work, or something else is going on (such as tongue-tie or other sucking issues) that needs to be addressed.
A good latch is essential for your comfort, and effective milk transfer by your baby. If you are having problems, get help as soon as possible to avoid running into even bigger problems down the road. The longer you wait to get help, the harder it can be to turn things around. If your reading this while pregnant, we highly recommend attending La Leche League meetings, or some other kind of breastfeeding support group before the birth of your baby, so that you have a chance to learn about normal breastfeeding from the pros: breastfeeding moms!
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Fleur Bickford is a nurse, lactation consultant, and mother of two. She’s passionate about helping families discover the joys of breastfeeding, birth and parenting, and providing parents with evidence based information. She is a private practice lactation consultant in Ottawa, Ontario. You can find more information about Fleur on her website, www.nurturedchild.ca.