Breastfeeding doesn’t need to be hard, and it certainly shouldn’t be painful. During my time helping women to breastfeed I’ve come across some of the same issues time and time again. The main one tends to be that the latch is sore. This can often be solved with minor adjustments to the positioning of mum and baby, and the way in which the baby is brought to the breast.
So here are my top 5 tips to a successful latch:
1) Position yourself! You are a pretty crucial part to this whole process you know, and so many people forget this as they desperately try to get baby to latch. So, get yourself into a nice comfortable position; ankles, hips and shoulders in line. Lie back if you want, maybe put a cushion in the nook of your back, put your feet up, breathe and chill. The more relaxed and comfier you are, the more freely your milk will flow. Oxytocin, the hormone of love, the happy hormone, drives the let-down and release of your milk. So, the happier, more relaxed and centred you are, the easier your milk will flow.
2) Position baby! Find a hold that feels good. For most people, this will probably start as “cross cradle”. This is where you bring baby in towards your body with the opposite hand to the breast that you are going to feed with. So, if the baby is going to feed off the right breast, you’d be using your left hand. Your hand cups baby’s neck and shoulder blades, leaving their head to freely move. If baby is very young and has little to no neck control, you may want to use a finger or two to help steady their head near their ear closest to the ground. Don’t put anything at the back of their head. Ensure that their body is right up against your body. Make sure their hands are not crossing their body or up at their face as this can cause issues in attaching.
3) Position the nipple! I always say to start with baby’s nose at your cleavage. When you are ready, slide baby towards the breast slowly. Once the baby’s nose is level with the nipple, stop. Think about your baby giving your nipple a wee nose
4) Attach baby gently but firmly. When baby starts to smell the milk, they will instinctively start mouthing their way towards it. Wait! When baby opens their mouth wide, push gently but firmly on their shoulder blades, pushing baby in towards you. You’re aiming here for the nipple to be as close to their top lip as possible, with the bottom lip further away, and the chin touching the breast.
To understand better the position of the nipple in the baby’s mouth, try dragging your own tongue along the roof of your mouth. The front is your hard palette, and towards the back, is the soft palette. This is where the nipple needs to reach! This is where things can go wrong. If the nipple is between the baby’s tongue and that hard palette, this can cause the irritation that leads to blisters and cuts on the nipple, which is usually the source of the pain. Again, usually this is caused by the top lip being too far from the nipple and the bottom lip being too close. I know it sounds counter intuitive, but that’s because babies don’t open their mouth to attach to the breast the way we think.
A baby tilts its whole head back to attach to the breast. Think of their jaw like a hinge where their chin is fixed and the whole top half of their head tilts back to attach (this is why I said earlier not to put anything on the back of their head!). So, with nose to nipple, baby’s chin is already further down the breast than the top lip. Once baby hinges its head back, you are all but shoving the nipple to the back of the throat. I like to think of tickling the roof of the mouth as you push the baby gently into place. (Don’t worry, they won’t gag!)
Baby should then move its tongue in a wave-like manner to stimulate the breast. This then leads to your body releasing prolactin, which signals the breast to make milk. Your milk is made to order – then and there. You do not store milk in the breast. Yes, sometimes there may be excess milk there, for many different reasons, but flatter breasts tend to mean milk with a higher fat content and any excess milk stored in the breast tends to be higher in water content.
And finally, but most importantly:
5) If it feels wrong, it is wrong! You could have what looks to be a picture perfect, textbook latch. But you can’t see where the nipple actually is inside baby’s mouth. So, if it is sore, chances are the latch is wrong. No one has x-ray eyes so if someone is telling you that a latch looks right, that doesn’t matter. It needs to feel right too.
If it’s sore, poke your pinky finger into the side of baby’s mouth to release the seal that they make with the breast. If you try and just pull a poorly latched baby off, you can end up doing more damage to your nipple. Ouch! So, release the seal of the lips first, then go back to step one.
Remember, you and baby are both new to this. Even if this is not your first child, it is the first feed with this baby and every baby is different. You BOTH need to LEARN this new SKILL. Yes, it is a natural thing, but so is walking and that takes time to learn. Maybe you’ll find for the first few weeks and months, it takes 5 attempts every feed before the latch is comfortable. That is ok. You and baby are creating muscle memory as you feed, so it will get easier and feel more natural the more you do it. Think back to the oxytocin. If you are not comfortable and happy, your milk is not flowing as well and baby won’t be happy either!
So, to recap:
- Position yourself – get comfy
- Position baby – close to you with the back of their head free to move
- Position the nipple – place baby at the breast, nipple to nose
- Attach baby gently but firmly – wait for the tilt to attach, top lip close to the nipple, bottom lip further away, chin tucked in
- If it feels wrong, detach safely and start again
A quick side note. Many people like to shape the breast with their hands. For example, baby is coming in to the right breast, baby is held with the left hand, and the right hand is shaping the breast. This can be beneficial if you have inverted nipples or large breasts. However, a word of caution – if you shape the breast all the time you are setting up the attachment, and then you let go when baby latches, this might cause the nipple to move and the latch could no longer be right. So, if you want to shape the breast, make sure the hand is far away from the nipple and won’t get in baby’s way, especially being careful to keep your hand away from baby’s chin area. Once baby is latched, you can slowly release the breast, taking time to adjust baby as needed if this causes the breast and nipple to naturally sit lower. Again, it can take a few attempts, but keep at it.
If you try this and pain persists or the baby is not gaining weight as expected, seek out trained individuals to help. There are free breastfeeding groups that you can go to and you can also reach out to your local IBCLC (breastfeeding consultant) for more help. There is also the breastfeeding National Helpline (link below) that you can call.
Do not be silent in your pain, and don’t let anyone tell you that it is normal and expected in breastfeeding! It’s Not!
Find a local Lactation Consultant: https://lcgb.org/find-an-ibclc/
How baby’s mouth opens at breast video: https://www.facebook.com/watch/?v=4509052812511095
National Breastfeeding Helpline: https://www.nationalbreastfeedinghelpline.org.uk/
Video of position of nipple in the mouth: https://www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfeeding-resources/positioning-and-attachment-video/
Local Facebook group run by the Breastfeeding Network: