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Latching 101 - The Steps of Latching

Latching 101 baby latches onto mom while nursing

An effective latch for your baby is a team effort. You bring your baby to your chest in a way that allows them to do their part of nursing effectively and efficiently. For you, it should be pain-free and enjoyable. Breastfeeding offers your baby much more than the best nutrition during their first year of life and beyond. 

The face, jaw, and oral cavity including the dental arches, palate, and teeth develop differently for babies who are fed from a bottle versus the breast.(1) Breastfeeding promotes wide jaws 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.

Breastfeeding involves a series of reflexive movements to help your baby find your chest, latch and drink your milk. The repetition of moving their body driven by these reflexes creates connections in their brain which is important to their growth and achievement of future developmental milestones.

Steps to successful latching

baby latching while doing skin-to-skin

  • 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 begin to flow. As you hold your baby skin-to-skin and stroke their back, you engage with them and deepen your bonding experience. Your baby being skin-to-skin allows them to be able to fully move their arms and legs without any restriction of clothes or a swaddle. Keep mittens off their hands so they can use them to 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 your body 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 lathing, pillows support you and your body will support your baby.
baby latching with good position
  • Positioning - It is tempting to hold your baby with their mouth directly in front of your nipple or you may have heard to 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. 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 otherwise put your baby at your chest 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 latching or you are stuck holding your breast through the entire time your baby is latched. Support your baby by having your hand on their shoulder blades. You can use your fingers and thumb to add additional neck support, 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. It inhibits their ability to tilt their head back, chin up, and instead their head is brought forward which interferes with their hyoid bone coming 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)
close up of baby's mouth positioning to latch
  • Chin to breast/chest contact - Your baby’s chin is important to the process of latching. 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 will touch the chest/breast first and their mouth opens wide.(4)
  • Gape and snuggle - A wide-open gape allows your baby to take in a larger portion of breast tissue, create a better seal near the corners of the mouth to avoid air intake, extend their tongue over their bottom gum line, and swallow more comfortably during feeding. As the chin touches your breast/chest, their bottom lip should land at or near the edge of your areola. Their top lip will come over your nipple and land just above your nipple. You will still see part of your areola 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 body 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 cues. If you are stressed or nervous, it will be reflected in your baby’s state and they may find it more difficult to latch. The release of milk or milk ejection reflex happens with the release of oxytocin. When you are stressed, oxytocin is inhibited. Begin the latch process when your baby is still sleepy, relaxed, and showing cues of putting their hands to their mouth, turning their head side-to-side, or licking their lips. Waiting longer they are likely to be fussing 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 is an opportunity for them to practice using their reflexes for feeding. You have the opportunity to make adjustments to how you position and support your baby so nursing is enjoyable. 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 other stages of latching or breastfeeding your baby is uncomfortable, get in touch with your IBCLC to figure out why and address the root cause.

Footnotes:

  1. https://books.google.com/books?id=jEIj1Zs7z3EC&pg=PA30&lpg=PA30&dq=dr+brian+palmer+mechanics+of+suck&source=bl&ots=Pl6IrquZEd&sig=ACfU3U0Ziu8tA_hliE_0TQTMm67vQCEBcg&hl=en&sa=X&ved=2ahUKEwiPmfHB99H0AhWUkIkEHfktDVwQ6AF6BAgCEAM#v=onepage&q=dr%20brian%20palmer%20mechanics%20of%20suck&f=false
  2. https://www.health-e-learning.com/resources/articles/when-the-back-of-the-babys-head-is-held-to-attach-the-baby-to-the-breast
  3. https://sites.oxy.edu/clint/learn/articles/Optimalpositionsforthereleaseofprimitiveneonatal.pdf
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3898526/

Other Resources:

https://nourishedyoung.com/blog/redefining-the-latch

http://samples.jbpub.com/9781284093919/9781284093919_CH01_GennaSample.pdf

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3986202/


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