Latching 101 - The Steps of Latching

Achieving an effective latch for your baby is a team effort. Your baby gives you cues for when they are ready to breastfeed and you respond by holding them in a breastfeeding position that allows them to do their part of nursing effectively and efficiently. Breastfeeding should be pain free and enjoyable for both you and your baby. It should never hurt. Breastfeeding has more benefits than just being food for your little one. It is a way to comfort your baby, bond together, offer health benefits to you and influence every aspect of your baby’s growth and development.

Breastfeeding promotes  wide jaw growth and a wide palate that is drawn down and away from the nasal cavity when breast tissue fills your baby’s mouth. Their tongue presses the breast against the roof of the mouth widening the palate and creating more space for the sinuses. The face, jaw and oral cavity including the dental arches, palate and teeth develop differently for babies who are fed from a bottle versus directly at the breast.(1)

Breastfeeding involves a series of reflexive movements to help your baby move towards your breast, latch and drink your milk.(5) Being able to practice every time they breastfeed helps the brain remember which muscles worked together to get the job of latching and feeding done. Using the correct muscles helps your baby feed best. If there are speed bumps like tension in muscles or oral restrictions, your baby may alter how they latch.Those compensations have a ripple effect into other areas of the body and future developmental milestones.

• Skin-to-skin - being skin-to-skin with your baby helps regulate their heart rate, breathing and nervous system. It releases oxytocin, the love hormone, and encourages milk to flow. As you hold your baby skin-to-skin and stroke their back, you engage with them and deepen your bond. Your baby being skin-to-skin allows them to use their body, arms and legs without any restriction of clothes or a swaddle that can reduce sensory input and limit how they move. Keep mittens off their hands so they can feel their way towards your chest and massage or knead your breast as they nurse.

• Postural stability - You should be comfortable while nursing your baby. Position yourself so gravity can hold your baby to your body giving your baby postural stability.(3) This lets them focus on latching and feeding more easily. Try a slightly reclined or laid back position. You may want to use pillows to support your body. During latching, pillows support you and your body will support your baby. When they have their hands on your breast, they have added support for their shoulders and neck.

• Positioning - It is tempting to hold your baby with their mouth directly in front of your nipple or line your nipple up with their nose. The trap of those positions is that when your baby opens their mouth wide, your nipple will no longer be in line with their nose. They will end up slurping the nipple in and have a more shallow latch. Instead, scooch your baby down a little lower than you think they need to be. Allow your breast to naturally hang where it may. If you have very large breasts, it may be helpful to roll up a washcloth and place it under your breast for a little lift. Position your baby at your breast based on where your breast is. Holding your breast can mean your hand or fingers are going to get in the way of your baby’s mouth when latching or you are stuck holding your breast through the entire time your baby is breastfeeding. Holding your breast might lead to you bringing your breast to your baby rather than bringing your baby to the breast and doing their part of latching.

• Support your baby with your hand on their shoulder blades. You can use your fingers and thumb to add additional neck support if necessary, but do not hold the back of their head. When the back of their head is being touched during the latching process, their reaction is to press their head back into your hand. They may fuss or refuse to latch because of it. Holding their head can change their ability to tilt their head back, chin up and instead their head is brought forward and chin down towards their chest. Their hyoid bone won’t be able to come forward in line with the other parts of their mouth and jaw for a deep latch. Holding the back of their head can stop the rooting, gape and tongue extrusion reflexes.(2)

• Chest to chest & chin to breast contact - When your baby is positioned belly to belly with you and below the nipple, their chest will press into yours. As your baby tilts their head back slightly in a similar position to when you are about to drink a glass of water, their chin becomes more forward, will touch the breast first and their mouth opens wide ready to latch.(4) 
• Gape and snuggle - A wide open mouth (gape) allows your baby to take in a larger portion of breast tissue, create a better seal near the corners of their mouth to avoid air intake, extend their tongue over their bottom gum line and swallow more comfortably during feeding. As their chin touches your breast, their bottom lip will be at or near the edge of your areola. Their top lip needs only to end up just above your nipple after latching. You will still see part of your areola above their top lip as you look down at your baby. If you are in a more upright position, make sure to snuggle your baby in close to avoid your bodies separating or there being a gap between their body and yours. Being in the reclined position naturally keeps your bodies well connected. Once attached, they will begin to suck and nurse in a rhythmic and gentle suck, swallow, breathe pattern.
• Relax - Your baby picks up on your feelings. If you are stressed or nervous, it will be reflected in your baby’s mood and behavior and they may find it more difficult to latch. When you are stressed or anxious, oxytocin is inhibited. Oxytocin is the hormone that triggers the milk ejection reflex or let down. Begin positioning and latching when your baby is still sleepy, relaxed and showing cues like putting their hands to their mouth, turning their head side-to-side, or licking their lips. Waiting longer, they are likely to be fussier and maybe even crying. Nobody does well when they have waited a bit too long to eat. As adults, when we wait too long, we gobble down our food faster and are less relaxed. It is the same for your baby.  
• Practice - Each time you feed your baby, it is a chance for them to practice using their innate reflexes for feeding. You get practice making adjustments to how you position and support your baby so nursing is enjoyable, too. During stress-free feeding, you deepen the bond with your baby and nourish both their physical and emotional needs through your breastfeeding relationship.

If you or your baby are having a hard time with any stage of latching or breastfeeding or your baby seems uncomfortable, get in touch with a skilled IBCLC to figure out why and determine the best solutions for you and your baby.