Trouble Latching: Overcoming Breastfeeding Challenges

Introduction

Newborn babies, in their initial few days of life, go through trouble in latching and sucking at the breast. If the problem does not resolve, the baby would then need help with it. A baby should be able to draw enough milk from the breast for successful and correct latching in order to gain weight. This reflex of sucking or latching acts as a signal for mammary glands (milk glands present in the breast) to produce and maintain enough quantity of milk for a baby to breastfeed. If a baby is not able to get sufficient breast milk, then it results in a decrease in nutrition and poor weight gain in the child. The poor capacity to draw milk out also hampers the supply of milk from the breast.

What Factors That Affect a Baby’s Ability to Suck or Latch?

There are various factors responsible for ineffective sucking or latching:

• Prematurity.

• Jaundice.

• Infections.

• Cardiovascular diseases (heart disease).

• Medicines consumed by mother.

• Loss of suckling reflex (inability to coordinate between sucking and breathing reflex).

• Other mechanical issues like tongue tie and cleft lip and palate.

All of these factors affect the baby's ability, directly or indirectly, to perform effective sucking or latching.

What Are the Steps to Be Followed for a Good Latch?

There are a few steps that can be followed by breastfeeding mothers for a better latch:

• Try to tickle the nipple with the baby’s lip. This technique makes the baby open their mouth wide.

• Check if the baby’s chin is not in tight contact with its chest.

• Aim the nipple just above the baby’s upper lip.

• Keep the baby’s lower lip away from the base of the nipple.

• Make sure the breast is filling the baby’s mouth and the baby's tongue is extended.

What Are the Signs and Signals of Ineffective Sucking or Latching Seen in Newborn Babies?

A few signs that indicate ineffective sucking by babies are:

• If a baby does not wake or cry for their cue for feeding.

• If the baby continuously latches on and then goes off the breast continuously.

• If the baby cues to feed less than eight hours in a day.

• If the baby cues to feed more than 15 to 20 times a day.

• If the baby tries to push away or resist latching on.

• If the baby sleeps within five to seven minutes of latching or sucking.

• If the baby fails to feed continuously for five to ten minutes.

• Reduction in frequency and amount of stool by babies (minimum of four stools per day is common among normal babies).

• Babies have bloating or feel gassy.

• Babies excrete frothy and greenish stool in the first week.

• Babies having trouble trying other feeding methods.

• Babies produce less than six diapers in a day (normal babies produce six wet diapers a day or more).

What Are the Signs and Signals of Ineffective Sucking or Latching Seen in Mothers?

A few signs of ineffective sucking or latching off by babies observed in their mothers are:

• Mothers with reddish scraped or cracked nipples.

• Mothers with sore, bruised nipples or areola.

• Mothers with creased or flattened nipples.

• Mothers with a history of mastitis or with one episode of plugged milk ducts.

• Mothers with minimum or no sensation or feeling for breast fullness and breast softening before and after nursing, respectively.

How Breastfeeding Can Be Performed in Babies With Troubled Latching?

Mothers may feel discouraged if the problem with sucking or latching continues for more than a week. Mothers can help their babies by breastfeeding themselves and by taking help from a certified lactation counselor. Until the latching off or sucking problems resolve, mother can help their babies in other ways:

• If the baby is not showing a cue for feeding, wake the baby after every two to three hours to feed them.

• Take help from a lactation counselor to learn a few breastfeeding positions.

• Learn a few breast massaging techniques or gently squeeze the breast to excrete milk in the baby's mouth while feeding.

• Keep track of the number of feeds, frequency of urine or stool, and the number of wet diapers a day to rule out improvements in sucking or latching.

• Mothers are advised to use a properly fitting electric pump to make sure all milk is removed properly.

• Keep track of babies' weight. Improvement in the baby's weight is a sign of improvement in feeding.

• Provide the baby with adequate calories as suggested by healthcare professionals.

• Try to take help from a few mechanical systems like nipple shield, feeding tube system, and other feeding techniques for providing better latch and effective or nutritive feeding.

• In case of any structural deformities in the baby's mouth observed, visit the healthcare provider to clinically examine, diagnose, and treat the underlying condition.

What Are the Best Nursing Positions That Help the Mother for a Better Latch?

A few nursing positions that help mother achieve better latching are:

• Crossover Position: It is the best position for newborns. In this position, hold the baby’s head and move towards the breast until the baby latches. Then cradle the head when the baby starts feeding.

• Cradle Hold: In this position, hold the baby on the same side of the nursing breast rather than the opposite side. A pillow can be used by the mother for support.

• Football Hold: This position is helpful for mothers with cesarean delivery. This position prevents unwanted pressure on the belly. In this position, the baby is usually facing the mother's face, and their legs are tucked under the mother's arm.

Conclusion

A good latch is very important for nursing mothers to feed their babies properly. It helps the baby to feed effectively till their hunger is satisfied. It is advisable to meet a certified lactation counselor if nursing mothers face difficulties in feeding the child or have poor milk ejection from the breast. Mothers should take their babies to healthcare professionals if their babies are having trouble latching due to the presence of any structural deformities. Early diagnosis through clinical examination of both the mother and the child to determine the cause of trouble latching or ineffective sucking is essential to proceed with treatment.