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How to Deal With Latch Problems

Too shallow, not enough breast tissue in your baby’s mouth is nearly always the source of latch problems and the cause of discomfort for you and your baby.

What I Feel...Pinching, stinging, pulling, pain.

Why this is happening?

Your nipple is sitting too far forward in your baby’s mouth.  If you see a white compression line across the face of your nipple it is being compressed between her tongue and palate. This actually pinches off the milk supply, frustrating you and your baby. She will let you know if the milk is too slow by detaching frequently or falling asleep. Your nipple should be free floating in the back of her throat.  Rarely, a tight lower frenulum or tongue-tie can be keeping your baby’s tongue from protruding far enough to grasp breast tissue along with your nipple. This can be diagnosed by your pediatric care provider or a certified lactation consultant.

Here’s the solution

You need your baby to open her mouth wide, to take your breast as deeply as necessary for your comfort and her milk supply. She will open wide if she is positioned with your body pressure against her belly, chest and upturned chin. She will open wide if she is cueing to eat, but not yet crying. She will open wide if she has learned that her hunger needs will be met by your positioning of her near your breast. She will open even wider when you stroke your nipple downward on her lower lip causing her to drop her jaw and tongue...and here is your moment to push her onto your breast deeply. Using the heel of your hand in between her shoulder blades, supporting her head with your thumb and forefinger, send her upturned chin forward onto your breast, hugging her body tighter into yours with your other arm. If you push the top of her head, forcing her chin down onto her chest and her nose into your breast, she will likely rear back. Be sure to get the most breast tissue into her mouth on her tongue side. Her top lip can be closer to your nipple with her bottom lip farther away.  Depending on the size of your areola, you might still see it extending beyond her top lip but all inside her mouth on bottom.  This would be one indicator that you have achieved an asymmetric latch.  Your pain will be noticeably lower with a proper, deep latch. Once your baby’s mouth fills with your milk, the pain should be less than 4 on a 1-10 scale.  You should not hesitate to gently stop the sucking and re-latch as many times as is necessary to achieve a pain level of less than 4. Remember, pain means trauma is occurring.  Once you have your nearly pain-free latch, lean back and let her pull even more tissue into her mouth as she sucks and swallows. Please set up a consultation with a board certified lactation consultant to fix your latch problems quickly.  A hands-on approach can be critical to keep you breastfeeding happily for a long time to come.

Paula Zindler
RN IBCLC

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