Latch

[ocelotka123]

Hi, I'm looking for some advice regarding getting a good latch - any tips, videos that you found helpful etc.

Essentially I had low milk supply due to formula top ups that were given at the hospital (I didn't know any better back then.. midwives "made" me do it!). I then worked with a private lactation consultant to increase my supply and drop the top ups. But now I find that baby's latch is not great and this is probably what contributed to low supply. He hardly gets any milk out unless the breast is very full or during letdown. There is definitely milk there as when I press on the areola, it squirts everywhere - but the baby doesn't seem to be getting any out!

I know I need to position his bottom lip and chin below the areola but I'm struggling with that. Even when he opens wide, he seems to slip off and go higher on the areola. Any tips or good videos I can watch that can help with this? I really can't afford seeing the private consultant again and there is a wait for the nhs consultant - I'm worried that my milk will decrease again by then! I also don't drive and there are no feeding support groups locally. So I can't have anyone physically help with the latch in the near future.

If you Google “from bump to breastfeeding”, the best beginnings website has some good videos. Also la leche league have useful resources and might have a support group near you.

Get tongue tie and lip tie ruled out as this can affect latch. Try the rugby hold as well, you basically hold the baby like a rugby ball on your side.

The NCT breastfeeding helpline is also good. My local breastfeeding support is available via zoom or in person. Does your local infant feeding team not offer remote consultations?

These were recommended to me. In the end the poor latch was due to undiagnosed posterior tongue tie and high palate.

themilkmeg.com/get-better-latch-exaggerated-latch-flipple-breastfeeding-technique/#:~:text=Use%20the%20%E2%80%9Cflipple%E2%80%9D%20technique%20to,after%20they%20have%20latched%20on

www.unicef.org.uk/babyfriendly/baby-friendly-resources/breastfeeding-resources/positioning-and-attachment-video/

This video really helped me! I don't know why as I'd looked at every other resource going but this just really helped me see what to do.

Best wishes x

Thank you. He doesn't have a tongue or lip tie (checked privately). He does have a high palate though.

I've watched the videos, thank you - but still can't get him on properly. Feel absolutely awful about it, I'm such a mess tonight. Ended up giving him a bottle of expressed milk as we both were just staring at each other crying.

I'm not sure remote support would be of much use - I know his latch is not right as he's not getting milk out, ideally I'd need someone to show me in person how to do it right. I will try contacting the nhs breastfeeding support person tomorrow.

ideally I'd need someone to show me in person how to do it right

^ that would be ideal but thousands of us new mums have learnt the latch from remote consultations only due to Covid so you can too!
You are doing great and keep up the pumping until you have cracked the latch. It took me until 12 weeks to have it all sorted with one thing then another, but then we were well away.

I actually managed to see an nhs consultant today (very lucky - I guess there was a cancellation!)- but she said that the latch looked perfect from what she could see, so couldn't really tell what the problem was. She recons that he's just not hungry when it happens and sucks for comfort rather than food.

I had plenty of supply but a weird shaped nipple on one side that none of my three babies could get along with. It was me, not them, that was the issue. In the end I just admitted defeat and fed mostly from one side. Topping up with a bottle of formula before nighttime bed, to keep them full.

You might find that it's easier on you to just accept, rather than fight, your body.

My other tip is to make sure the baby has one nostril uncovered when on your boob. This is needed so they can breathe! Lots of babies will come off a boob simply because their nose is covered and they can't suck and breathe at the same time.

How old is baby and what is making you think there is a problem with the latch/low milk supply? Is weight not sticking to the curve or too few wet/dirty nappies? It is often the case that what seems to be a fussy baby is actually just normal infant behaviour and looking up 4th trimester can help. It sounds like you're doing such a great job and feeding a baby with a high arch palate can be really challenging.

If the problem is the high palate, the documents here and here have some useful information on feeding a baby with a high arch palate. Also search the 'flipple' technique where you flip your nipple up before baby latches. If baby is struggling to transfer milk it can also help to switch sides every 5 minutes during a feed so baby can get that easier to get milk and doesn't have to work so hard (and tired themselves out in the process).

The main thing is, while breastfeeding can be challenging with a high palate, it absolutely can be done and it's very likely to get better over time. As baby grows and their mouth gets bigger they can take in more breast tissue. Feeding issues can resolve at around 4 months for many. If baby is struggling with weight gain and you're given advice to top up it's really important to also pump to maintain your milk supply if you're hoping to continue breastfeeding. You're doing so well.

@Mumsneat He is 6 weeks old. I definitely had low supply as there were barely any swallows after a few mins and the baby was always still hungry after the breast and he wasn't gaining weight (hence the top ups). I've upped the supply now by lots of pumping and have been able to drop the top ups. He's gaining weight well.

Regarding latch, as I put on the OP, he struggles when the breast is not as full. The nipple also comes out a bit pinched and can feel a bit sore as if it's rubbing slightly. The nipples are not cracked but are a bit irritated/red. I wonder if this is due to the high palate.

Thanks for the links, I will have a look. I've tried the flipple but couldn't get the hand of it at all! I have also tried switch nursing but it makes no difference when the breast is empty-ish. He drinks really well from a fuller breast so there is no need to switch.

I wonder if the consultant is right and he's just not hungry at times and wants to suck rather than feed - hence the empty breast (because he's already had a feed not long ago) and no swallows.

And hopefully as you say, I will get easier when he gets a bit bigger!

Sorry if I've missed this, but how do you know baby isn't getting milk? If they're gaining weight and having wet and dirty nappies. They're doing just fine (as long as latch is comfortable!)

Around the 6 week mark, babies get so fussy, on and off breast and are stimulating the breast to make more milk. Can you just have a few days in bed or on sofa with baby just letting them latch and unlatch when they want to?

Re. Latch, best advice I was given is if in cross cradle hold, pull baby round your body by feet so they have to almost reach up for breast, chin to skin (not nose to nipple!).

I know how you feel though, it's so difficult. I breastfed but eldest until nearly 3, through tongue tie etc but my youngest, struggled so much. No weight gain, and was just to small and tired to feed effectively so moved to formula by 6 weeks. You seem to be doing all the right things!!

I agree with @sammielouise, if baby is having good nappy output and is gaining weight it sounds like he's getting plenty of milk.

It can be hard once there has been an initial problem to then trust that your body is making enough but it sounds like you're doing really well.

Non-nutritive sucking is really normal infant behaviour and important for them. Breastfeeding is about more than milk - baby gets comfort, pain relief, a sense of calm and reassurance, bonding with you and it can signal to your body that baby wants more milk and up your supply when needed.

As long as baby is gaining weight and having the right number of nappies (and you're not experiencing pain), keep doing what you're doing sounds like it's going really well.

Sorry, just seen you said your nipples feel pinched and irritated. That could definitely be because of the shape of baby's palate. A better latch would hopefully resolve that issue for you as you shouldn't be experiencing pain.

Perhaps try the laid back nursing position - it helps use gravity to get a deeper latch.

www.nct.org.uk/baby-toddler/feeding/early-days/laid-back-breastfeeding-benefits-and-uses

@sammielouise @Mumsneat thanks both. Regarding baby not getting milk, it's when he's sucking vigorously but not swallowing or only swallowing very occasionally (e.g. every 10-15 sucks). He then gets more and more frustrated and fusses. It only happens once a day or so, usually in the afternoon/evening when he cluster feeds. The rest of the feeds he's swallowing well and clearly getting enough milk then. But yes I definitely question myself now and find it difficult to trust my body! Baby lost almost 10% of his birth weight and it took over 3 weeks to get back to the birth weight, which also involved a hospital stay due to low blood sugars so naturally I get anxious about his milk intake now!

It's so hard in the early days isn't it! Honestly though, it sounds like baby is taking what they need, and the rest of the time it's for comfort etc which is so normal! Just keep tracking weight gain and nappy output. Obviously pinched nipples and pain isn't normal, so could be the high palette or sign that the latch has gone shallow, try and take baby off and relatch when that happens to avoid damage to nipples.

No one tells you how hard breastfeeding is, do they!! I wish I'd have carried on with my second, but was pressured into formula due to the consistent failure to gain weight and her prematurity - so although it was probably needed, still hurts, as she got bigger she likely would have improved! Good luck!!