Some quick tips for a good latch

Elvish, BSN, DNP, RN, NP

For moms who are breastfeeding, a good latch is supremely important. If not, nipple pain will soon ensue - even if the improper latch is held for just a few minutes, those few minutes can have a long-lasting effect. Additionally, if the baby's mouth is not wide open with enough breast tissue in the mouth, he will not get the full amount of milk possible.

Make sure Mom is comfortable with her back, neck, shoulders, and arms supported.
If baby is sleepy, it helps to undress him down to a diaper and put him skin-to-skin with Mom. Generally in about 15 to 30 minutes, baby starts showing feeding readiness cues (rooting, soft calling sounds, hand-to-mouth motion, etc.).
Regardless of position used, having baby and Mom tummy-to-tummy facilitates easiest latch.
Have mom tickle baby's lower lip with her nipple. When baby opens her mouth wide (as though yawning), have Mom bring baby to the breast quickly. Sometimes it helps to remind mom that she will not hurt baby by doing this - I often liken it to putting one's face into a pillow.
Have mom compress her breast tissue so that it is perpendicular to baby's mouth, much as would would do when eating a sandwich. This facilitates getting as much breast tissue into his mouth as possible.
Have mom squeeze a few drops of colostrum onto her nipple, or if no colostrum can be expressed, a few drops of water (or formula) will work too. Sometimes this helps an otherwise-uninterested baby realize that there might be something worth investigating!
Keep baby's hips, shoulders, and head in a straight line. If baby's bum is on a lower level than his head, he will often instinctively bite down when he should be opening up. That's when Boppy pillows and such come in really handy. A couple rolled up/folded blankets will work just as well. I discourage the use of regular pillows because they tend to sink in after a few minutes and baby's bum drops.
The first few seconds of the latch may be a bit uncomfortable, especially in the first few days, but the discomfort should ease up after a few seconds and baby is sucking rhythmically. If mom feels any sort of pinch or biting, she likely needs to break the seal (inserting her finger into one corner of baby's mouth) and attempt to re-latch.
Assess baby's mouth for short or tight frenulum (also known as ankyloglossia, or tongue-tie). This can affect baby's ability to open his mouth and/or put his tongue underneath the nipple. The end result is that baby's tongue ends up hitting the tip of the nipple with each suck/swallow rhythm, which leads to nipple pain. Mom might also have characteristic 'striping' of her nipples if this is the case. Often a clipping (frenulectomy) will solve the problem quickly and relatively painlessly.

One other thing, which I find vitally important, is to have the mom assume that breastfeeding will work. Often first-time breastfeeding moms are really worried that they will not have sufficient milk, or that their baby will never figure out how to latch. It's so important to reassure these moms that the overwhelming majority of moms can exclusively breastfeed should they choose to do so. When they can and do, it is a beautiful thing to see.

Some quick tips for a good latch

About Elvish, BSN, DNP, RN, NP

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