Week three, the weeks fly by, the most common question I found this week (and most weeks) is…
“Have I got the latch right? it really hurts”
Most mama’s wonder this in the first week, occasionally even fourth time round, because even if you are an experienced breast feeder each baby is different.
First before I even look at the latch I talk about skin to skin, as I said in my first feeding blog two weeks ago (evabaydoula.blog/2016/12/13/new-mamas-common-early-breast-feeding-questions-answered-week-1/), it is never too late to get naked with your baby and partner and snuggle in bed, skin to skin stimulates your babies instincts to feed, as it keeps him feeling safe, it creates the right environment to stimulate your oxytocin levels (the shy love hormone that also indiuces your milk let down), your baby can smell your milk (your baby will know your milk from other mothers, it is that unique to them!), and skin to skin regulates their heart beat, breathing and temperature levels. Skin to skin snuggles in bed is one of the loveliest things you can do with your newborn.
Even if you have been separate after birth if your baby has needed extra support in a special care baby unit in hospital I highly recommend trying skin to skin as something you can do to help with bonding and breastfeeding once you are able to have time together, it is never too late.
When I’m looking to see if the latch is right there are a few things I look for. It starts before you feed.
Firstly I look to see if you are comfortable, if you are comfortable and relaxed your baby will be too. You will need good support around you, perhaps cushions for supporting your arm holding your baby, maybe one or two on your lap so you can bring your baby to your breast and not slouch forward bringing breast to baby (as this can cause you back ache and it can cause your baby to move and a bad latch as your will both struggle to maintain a good feed if you slouch forward).
I then look at your baby’s position on you, he should be facing you (so he doesnt have to strain his neck), tummy to tummy, head in crook of your elbow. I then encourage you to encourage your baby to open their mouth wide by aiming his nose level with your nipple so when he opens his mouth he will get a big mouth full of the areola around your nipple too. If your baby doesn’t get enough areola and only sucks from your nipple it will become very sore and he wont get much milk, as he needs to be able to press on the ducts with his tongue to get the milk that is sitting in the resevoir ducts. If he is not opening his mouth wide enough you can stimulate his natural instincts and reflex by stroking his cheek a little using your finger or your nipple.
(Image i found via google)
If the positon I described (the cradle hold) doesn’t feel right to you there are a number of others you can try! All of these will work well if you are comfortable and your baby gets a good mouthful of the areola.
I’ll continue to check throughout the feed that you are still comfortable, as I said just now, you being uncomfortable can cause your baby to feel uncomfortable too and can cause your baby’s position to move during the feed.
Pain is the biggest topic with the latch, many people mention toe curling pain in feeding. Pain in feeding can be normal to start with in the first week as your nipples and tiny tubes inside them are very sensitive and need to toughen (they have likely never been stimulated so much!). The difference with pain of a bad latch or normal early feeding pain is that if the latch is good the pain will ease after a few moments and feeding will be comfortable, it also wont last longer than a week or ten days. If the latch is wrong the pain will continue throughout the feed and blisters, cracks and bleeding can occur.
If the pain continues you will need to take your baby off and reposition trying to get more of your breast into the babies mouth. To take your baby off the best way is to break the suction by gently putting your little (clean) finger into the corner of their mouth. Once your baby is off then start again to try to encourage him to open his mouth wide and get a good mouth full of you areola around the nipple.
When you take him off your breast check your nipple for indentations, or odd shapes that do not look normal. Your nipple will naturally be softer and stretchy but if it has ridges or is flatter at the top or bottom, its a good indication the latch may be wrong too.
Other possible causes for pain could be tongue tie or thrush. If your baby is tongue tied, (this means the skin attaching your babies tongue to their mouth is big and restricting movement in the tongue), they may not be able to get a good latch and suckle comfortbly which will therefore cause pain in feeding. Your midwives or health visitor will notice this early on and can cut it easily correcting the tongue tie immediately.
Thrush (Candida) is a common fungal infection. If you find you have thrush you will notice a white film or white spots in your babies mouth, a nappy rash that wont clear up, and your baby may be unsettled when feeding. You may have pain and itching in one or both breasts. Mention it to your doctor and they will provide you with a anti fungal cream or antibiotics to clear it up. I found washing with calendula infusion also helps heal from candida too.
When your baby is feeding and you are both comfortable I will look at how your baby is feeding, his cheeks should be round and moving slightly with the suckle movement but not sucked in, he will be making normal soft breathing sounds with an occasional swallow. He should not be making squeaking noises with his mouth as this would indicate he is sucking in air which would mean the latch isn’t quite right.
Once your baby is full after a good feed and nice latch he will have a full sleepy satisfied look as though he is drunk on milk.
(Image I found on google)
As common as this question is and I find I answer it a lot it is tricky to get it down on paper as I find it is so instinctual.
I really want to say also that if you are struggling please know that each day is different, take it a day at a time, keep in your mind ‘this time next week it will be better’. You are both learning, you both have instincts and with time and patience it will happen.
I have one final top tip I often tell parents. Have a warm bath with your baby! If your baby has been struggling a little with feeding the warmth of the bath and nestling next to your breasts in the warm water will stimulate them to wake up and feed, it has never not worked in my experience! You will see your tiny snuggly newborn ‘wake up’ and often be as active as they were in the womb.
One last thing…on my ward round most women I see have a myriad of creams or ointments for sore nipples, some are great and some not, each of us is different and we all find the creams different, if you use them make sure you wash it off before you feed your baby. My favourite healing ointment is your breast milk, it is full of anti bacterial, anti fungal, anti inflammatory goodness, squeeze a little from your breast after feeding and rub it into your nipple, let it air dry and you should see a huge difference in the speed you heal! Your breast milk is also great on nappy rash, conjunctivitis, and healing your babies belly button cord, it is natures magic.
I hope I havent overloaded you! Please take what you need from this article and my others, if you have any questions following this article please do feel free to get in touch.