A latch is good if:
- Parent is pain-free
- Baby is drinking well with audible swallowing, and coordinated suck, swallow and breathing,
- Baby is having plenty wet and dirty nappies relative to baby’s age
- Parent’s supply remains responsive to baby’s demands
If all the above are happening, it doesn’t really matter what the latch ‘looks’ like.
There are a few basic things parents can watch out for and try to adjust in order to achieve an effective latch.
Most parents find cross cradle and cradle hold the easiest at first. There are many different types of holds such as cross-cradle, laid-back, koala hold, football hold, side-lying etc.
The most important thing is that you find a position where you are comfortable and supported. Lots of pillows and cushions nearby help with this. A small footstool is also very helpful to raise your legs, thus supporting your baby to stay high up onto the breast, and not slip off if your arms get tired.
It is also good to try the following exercise yourself: lower your head so that your chin meets your chest. Try to open your mouth wide. It’s difficult isn’t it? Now, raise you head and look up towards the sky and open you mouth. You can open so much wider. It’s good to think about this when you are latching your baby. You want baby’s body snuggled up close to you so that he/she has plenty of room to tilt his head back. It’s also important not to have your baby’s body too far forward (towards your elbow) when in the cradle or cross cradle position. Your baby’s nose should be directly in front of your nipple before latching, so that he/she has to reach up and over your nipple for a deep latch. If your baby’s nose is not in this position starting out, then adjust your baby to the left or right until it is. Notice in the image of the Cradle Hold, that the baby’s head is centred on the mothers forearm between the wrist and the elbow, and not tucked into the crook of the mothers elbow. This is where many parents make their first mistake. Center your baby’s nose over the nipple. It may look wrong to you at first but you will find that it will actually ‘feel’ right when latching.
It is best to tease the baby’s upper lip with the nipple, and wait for baby to open wide. When baby opens wide, bring your baby to breast and not breast to baby. This is a very important point! Once baby has latched, bring the baby’s body and hips in as close to you as possible, ensuring that the lower jaw is embedded in the breast. Count to 20, and see how you feel.
You want your baby’s lips to look like a ‘K’ and for the upper and lower lips to flange out around the breast. See picture below. Some babies won’t flange their lips out and that is ok as long as the mother is comfortable, with no nipple pain. The baby in this picture should ideally be brought in closer to the mother so that his chin is buried in the breast and both cheeks and nose are touching the breast also.
Aim to have your baby lead with his chin. Position your baby in close to you: Tummy to mummy. Rest the baby’s nose directly across from your nipple and areola. Express a little milk and rub it to baby’s lips to let him know its there. Wait for him to open his mouth as wide as he can (wider than your nipple), and then bring him gently on to the breast. If the latch looks shallow, wait for a few seconds. Baby’s can usually deepen the latch themselves in response to milk flow. If it is painful and you have waited 15-20 seconds, unlatch the baby using your finger and try again.
Baby is latched well if you see movement at your baby’s temples with sucking, the jaw moves up and down an inch or more, and there is an audible swallow. It may take a minute or two after latching to hear this, depending on how quickly your milk lets down. Before your milk ‘comes in’, you may find it more difficult to judge as the milk is not copious in volume yet. If you look down at the area between the babies chin and neck you will see it lift up when the baby swallows. You may also see movement of the top of the jaw where the ear meets the cheek. It is also a good sign to see some movement of your breast near baby’s lips.
Signs of Good Feeding:
- Seeing milk in the baby’s mouth
- Hearing frequent swallows
- Rhythmic suck, swallow and breathe with regular pauses
- Softer breast after a feed
- Age appropriate output (see chart below by the HSE)
6. Leaking from the other breast, or feeling the let down, often described as a pulling, tugging or briefly painful sensation. Some women don’t leak and that’s normal too. You may notice a change in the baby’s sucking rhythm from rapid to slower and deeper.
7. Baby is relaxed and satisfied after a feed. Baby latching off by himself is a really good sign of satisfaction.
8. Weight loss of <10% in the first 5 days, and a return to birth weight by 2 weeks old.
This video by Dr Jack Newman is old but gives a great visual guide and explanation of how to achieve a good latch:
Further tips for achieving a good deep latch:
- Keep your fingers way out of the way, especially the fingers that are holding the lower part of your breast, so that your baby’s chin has lots of room to anchor in the breast.
- Hold your baby up high across your body when baby is in cradle or cross cradle hold. This will prevent him/her from sliding off the nipple when your arms get tired, or you adjust position. Use pillows to support your baby’s weight.
- Wait for your baby to open wide before trying to latch.
- If you have large breasts, it may be wise to roll up a muslin cloth and place it under your breast. This will lift up your breast and make it easier for baby to stay latched on.
- After you have latched on your baby, count to 15-20 seconds. Babies are instinctual, and can often deepen the latch themselves in order to get more milk.
- Make sure baby’s chin in buried in the breast and the nose is free.
- Observe for the 4 points of symmetry when baby is latched on. The chin, both cheeks and the nose must be touching the breast.
- If your latch is feeling a little uncomfortable, try adjusting your baby while he/she is latched on by looking for the 4 points of symmetry, and bringing your baby across your body to the left or right by a few centimetres. Often, baby’s nose is buried in mums breast which is a sign his body is too far forward. Bring the baby back across your body and pulled in close.