Proper Breastfeeding Latch and Sucking

Is your baby’s latch and sucking correct? Here’s how to tell:

• You see the pink of baby’s lips. This tells you that baby’s lips are turned outward rather than tucked tightly inward.
• There is a tight seal between the baby’s mouth and the areola. Baby has a good mouthful of breast.
• Much of the areola (at least a one-inch radius) is inside baby’s mouth. As the baby is sucking, you do not see the base of your nipple, but only the outer part of your areola.
• Baby’s tongue is between the lower gum and your breast. If you pull down gently on baby’s lower lip, you should be able to see it. With a good latch-on, baby’s tongue extends over the lower gum, forming a trough around the nipple and cushioning pressure from the jaw.
• Baby’s ears are wiggling. During active sucking and swallowing the muscles in front of baby’s ears move, indicating a strong and efficient suck that uses the entire lower jaw.
• You hear baby swallowing. During the first few days after birth, baby may suck 5 to 10 times before you hear a swallow. That’s because colostrum comes in small amounts. You may have to listen carefully to notice swallows. After your milk has “come in,” swallowing will be obvious. After the baby’s initial sucking has triggered the milk ejection reflex, you should hear a swallow after every suck or two. This active sucking and swallowing should continue for five to ten minutes on each breast.
• Milk does not leak much from the corners of baby’s mouth. Baby swallows the milk instead.
• You don’t hear clicking sounds, which would indicate that baby does not have his tongue positioned correctly and is latched on incorrectly.
• You do not see dimpling (the middle of baby’s cheeks caving in) during sucking. This would indicate that the baby has a poor seal on the breast and is breaking latch and suction as he moves his gum and tongue. Pull baby off and try latching on again.

Eventually, you will know that your baby is latched and sucking efficiently by the way it feels. If you have a lactation consultant helping you, (which is a must for a first-time mom) pay close attention to how your nipple feels after the two of you have gotten the baby latched on correctly. There should be no pain. Also pay attention to how the sucking feels on the areola. You will actually feel a tingling sensation as baby draws the milk out of the milk sinuses. There will be no doubt that your baby has a solid and secure connection to your breast.

When baby is not latched on securely to the areola, the painful sensations in your nipples will register “Red alert! Lousy latch-on.” Do not persist with an incorrect latch-on. Take your baby off and start again. Be sure that you wait until baby’s mouth is wide open and the tongue is down and forward before pulling baby onto the breast. Rushing the latch-on results in baby gumming just the nipple. You’ll get sore and baby won’t get enough milk.

Be patient. Take a few deep breaths, calm baby down, and stay calm yourself. It takes a week or two for most mothers and babies to become skilled at breastfeeding.

What to do if you just can’t seem to get your baby’s latch and sucking technique correct

With prompt attention, latch and sucking difficulties can usually be fixed within a few days. Here’s what to do:

• Get help right away from a lactation consultant if you’re having trouble latching your baby onto the breast or feel that your baby is not sucking well. A lactation consultant will show you how to get baby to latch on better. She can also show you how to teach baby to suck correctly. Some newborns need to be taught how to suck more of the areola and with the back of the tongue instead of just sucking on the front of the areola with the front of the tongue. Incorrect sucking also causes sore nipples.
• Make certain that your baby is getting enough to eat. The first rule in solving breastfeeding problems is to feed the baby. Keep track of baby’s urine and stool output to determine if he is getting enough milk. After your milk has “come in,” baby should have 4 to 6 wet diapers a day (6 to 8 if you’re using cloth) and at least 2 to 3 substantial yellow, seedy stools. Some babies have a stool with every feeding. (The frequency of bowel movements decreases after the first month, as babies intestines mature.) If your baby is losing weight and is not having an adequate amount of wet diapers and bowel movements, talk to your doctor about supplementing your baby’s feedings until either your milk comes in or your baby learns to latch-on and suck efficiently.
• If supplementary feedings are necessary, avoid using bottles. Supplements can be given with a cup, spoon, eyedropper or feeding syringe, or a nursing supplementer. Using one of these will prevent the possibility of nipple confusion, caused by feeding baby with artificial nipples.
• You may need to use a breast pump to keep up your milk supply until baby becomes a more efficient breast feeder. The milk you pump can be given to your baby. To establish and maintain a milk supply for baby who can’t yet nurse very well, you need a high-quality electric pump. These can be purchased or rented.
• Don’t be discouraged. Breastfeeding does not come naturally to most breastfeeding pairs. Moms need to learn how to help their babies latch-on correctly and babies need to be taught how to suck correctly. This takes time and lots of commitment, like any worthwhile goal in life. Remember, it does get easier. Don’t give up!