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Top 5 Breastfeeding Difficulties: Difficulty Latching? We've got your back!

We have all heard the horror stories of breastfeeding... everyone has a cousin who had a, b, and c and that she felt like breastfeeding was torture because of x, y, and z. And you know you want to breastfeed because you heard its good for the baby, but now you are mentally preparing for the worst ….right?

But we are here to tell you that it doesn't have to be like that! A lot of problems actually come from the infant latching in a way that causes pain, poor milk transfer, etc. Neither one of you is doing anything wrong! It is pretty common and with some minor adjustments with a lactation specialist, you won't have to constantly 'brace yourself' for the worst.

How do you know if you have a good latch?

A proper latch...

Having a proper latch is important for the effective transfer of breastmilk. If your baby is not latched correctly, it could cause issues with milk transfer which also may cause pain for Mama.

Breastfeeding should not be uncomfortable or painful (other than a slight tugging on the breast), therefore if you are experiencing any trouble, you may need additional help from a lactation specialist.

Possible issues...

Some problems that may occur with an improper latch include painful nipples, chapped/cracked nipples, or engorgement from pressure (because the milk is not being transferred) which could then lead to mastitis (a serious medical condition that could be dangerous to the mother).

Breastfeeding positions...

There are a few positions that every mother and baby dyad can choose from to meet their breastfeeding needs. These include the regular 'cradle position', the 'football' hold, 'laidback position', etc.

Each dyad has to figure out what position works best for them, but here are some tips for a successful breastfeed!

Mama and baby should be tummy to tummy. This tip helps to ensure that the baby is facing Mama with their head, shoulders AND hips. This also helps lead to optimal comfort and breastfeeding latch.

The second thing we look out for is the actual position of the nipple in the baby's mouth. Your baby should be asymmetrically latched on the areola so that the nipple faces the roof of his/her mouth.

To achieve this--- while positioning for a feed, your baby should have their nose adjacent to the nipple. The chin should meet the breast first. When latched, there should be more areola above your baby's mouth than below.

The corner of the baby's mouth should be at a 145-degree angle. This indicates that the baby has a good mouthful (of breast tissue) and there will be no painful nipple sucking for the mother.

Lastly, make sure that your baby's nose and chin are close to the breast. When latching, bring your baby to you, don't bring your breast to the baby! This simple act may decrease a large number of problems you are having while breastfeeding.

Action Item: Make a checklist of these items and see if your baby has each one. If not, you may need to make some simple adjustments.

"My baby seems to be latched but I’m not sure if he is actually drinking my milk?"

One of the ways to assess a latch is to 1) look at the jaw motion and 2) listen for sucking and swallowing. While feeding, a jaw motion should look more like its 'rocking' vs a straight up and down motion.

You may also hear/see a difference in sucking vs swallowing. Swallowing makes a distinct sound (as if you were gulping a drink) while the jaw drops slightly to open the throat. If you can only see a suck and cannot hear a swallow, then the baby may not be transferring milk.

Another way to make sure there has been milk transfer is through assessing the baby after a feed. Your baby should look 'milk drunk' or very relaxed and sleepy. The baby's hand will come off the breast and hang loosely like the rest of the body.

Another option: You can weigh your baby before and after a feed, showing an increase in weight post breastfeed. This will show only a few ounce difference, however, will prove that your baby did indeed receive milk.

Action Item: Look for jaw motion during a feeding and body language after. Listen for a swallow or gulp to see if milk is being transferred.

OR look at/inside their mouth--- milk residue is a great sign that the baby is transferring milk.

A long term latch assessment would be to watch your baby's weight overtime to make sure they are 1) not losing weight and 2) they are gaining the proper amount of weight according to accepted growth charts.

Please note that breastfed babies may lose a bit of weight within the first week after birth. This is normal as long as the weight reduction is no more than 5-7% of their birth weight.

How long should breastfeeding sessions be and how does that relate to latch?

For lactation counselors, the length of the breastfeeding session can be an indicator of a multitude of things.

Most importantly, the length of the breastfeeding session can help the lactation counselor understand how successfully the baby is transferring milk/how much milk he/she is getting.

How long should the breastfeeding session last?

A feeding session should last ~15 minutes. This time absolutely fluctuates with each individual baby (by ~5 minutes or so is normal).

If the baby takes significantly less time then above, he/she may be too tired/fussy or fatigued to complete a feeding. This baby may 'give up' early, indicating a milk transfer issue or latch problem.

Likewise, the baby's that take longer than the above time frame may be suckling at the breast for self-soothing purposes rather than breastfeeding. This problem may hinder mom from completing any other tasks that do not include feeding her child but this may be favorable for some.

How often should my baby breastfeed?

Your baby will feed 10-12 times in a day.

Interestingly enough, moms that successfully feed their baby 10-12 times daily feel like they have a problem with their milk supply. BUT in all actuality, they are feeding their baby the perfect amount.

If your baby is indeed feeding less that ~10-12 times daily, this indicates a problem (usually regarding poor milk transfer).

Fun Fact:

Around the world, most babies breastfeed for 140 minutes daily.

A simple way to check if your baby is getting enough milk is by adding the time of each breastfeeding session together. The total should be about 140 minutes per day. *A baby that nurses 8 times a day for ~17 minutes will get the same amount of milk as a baby feeding 12 times a day for ~12 minutes.

Studies have shown that the breastmilk consumed by infants who feed more often is higher in fat content, and therefore is more conducive to healthy growth and development.

Action Item: Keep track of how long your feeding sessions are and how many (through your log that you are keeping from the low milk supply section), and add the minutes up. They should equal somewhere around 140 minutes total.

Difficulty Suckling

Sometimes, babies have a difficult time suckling, whether its muscle development or coordination and its something that they have to grow and work on. This happens most often in infants that were born prematurely. Often they have a lower muscle tone and their coordination is lowered due to their young gestational age. Never fear, as long as they are given time to build those muscles with some therapy, many babies are able to successfully breastfeed! All you have to do is keep your milk supplies up during this time!

Sometimes, for babies that struggle but are still able to suckle for some amount of time, they may have difficulty initiating the milk letdown. They may get frustrated and become overwhelmed and pull away from the breast. That's totally normal and okay too, its nothing you have done, so don't worry! One way to help your little one start that flow is to hand express or pump a little first just to get the milk letdown. That way they don't have to work as hard at first and they can work on the development of those little muscles-- possibly making it easier as they grow!

If you read this information and it resonated with you today, we would love to talk to you about some of your fears and struggles with breastfeeding. Continue to follow along with us on the "Top 5 Breastfeeding Difficulties" series and continue to learn more!

Action Item: If you think this may be an issue for you and your little one, working with a lactation specialist may help to optimize your baby's latch with little adjustments which can help to increase milk transfer and increase milk supply! (Hint-hint Mamas Maternal Health)

Reference: The Lactation Counselor Training Course Notebook (2018)., Healthy Children Project, Center for Breastfeeding

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