Latching

How do I latch my baby?

Latching happens when the baby takes the nipple, the areola, and the structures underneath the areola into the mouth and holds on using suction. Older babies can generally latch themselves but younger ones may need help. A mother may choose to latch her baby if latching is painful. To latch a baby, choose a breastfeeding hold and position the baby at the breast. Gently tap the baby’s top lip once with the nipple and wait for the mouth to open. Once it is open, bring the baby toward the breast. The chin should lead a little. If the baby is in a proper position, the nipple will point roughly toward the back of the roof of the baby’s mouth. Once latched, the nipple should be far back in the mouth.

A) Describing the latch

Latching is the process of the baby bringing the nipple and nipple root into the mouth and using suction to hold them in place. Once latched, the nipple needs to be far back in the baby’s mouth to prevent nipple pain and damage and to allow the baby to get enough milk.

In the first two months of age, babies may need a little help in order to latch. As babies get stronger and more experienced, they can latch themselves once they are positioned in front of the nipple. Toddlers can position and latch themselves. Mothers may choose to help the baby latch if latching causes pain. 

The video below shows a baby being latched in a cross-cradle hold. The mother is sandwiching her breast to shape it. We have tucked the baby's right arm under the breast so that the latch can be seen. It should not normally be in this position but rather should be circling the breast. 

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B) Latching your baby

Mothers using a V-hand position. Photo by Luiza Braun on Unsplash.

Consider the following steps to latch your baby.

1) Wait for hunger signs

Before starting to breastfeed, the baby should show clear hunger signs.

Happy hand sucking is not a sign of hunger. Babies having evening fussies can give confusing hunger signs as they may alternate between hunger and being unsettled.

Avoid letting the baby get too hungry and start crying as crying babies are very hard to latch. They need to stop crying first. This situation can also be brought on by giving a pacifier to the baby as they can mask the early hunger signs. When the baby finally spits out the pacifier or it is removed, the baby may start crying right away from hunger.

2) Position the baby

Choose a breastfeeding hold and properly position the baby at the breast.

3) Signal the baby to open the mouth

In order to latch the baby, the baby’s mouth needs to open.

Gently tap or touch the baby’s top lip once with your nipple and wait for the mouth to open. If it doesn’t, tap again after three or so seconds. We call this “knocking on the door” as it needs to be respectful and you should wait to see if someone answers before knocking again!

Tapping requires that either the baby or the nipple move. This can be done by:

  1. Moving the baby’s head and body slightly toward the nipple.
  2. Moving the breast:
    • By raising and lowering the shoulder closest to the nipple.
    • By placing a fingertip above the nipple and gently pulling the breast up and down.
    • By moving the breast slightly while holding it (Altuntaş 2019).
      • In a C-hand position as with the sandwich technique.
      • In a V-hand position and placing the index (pointer) and middle finger on either side of the nipple.

Some mothers tap more than once or don’t wait long enough for the baby to respond before tapping again. The baby, presented with a moving nipple, can’t latch and gets frustrated and mad. Pretty soon everyone is upset.

Babies under one month will open their mouth wide like a little bird but those over one month will only open part ways.

4) Bring the baby onto the breast

As soon as the baby’s mouth is open nicely, bring the baby toward the breast. Younger babies can benefit with a little pressure from behind the neck and upper back. This can be done if the baby is in the cross-cradle or the under-arm hold. The chin should lead a little.

If the baby is in a proper position, while latching, the nipple will point roughly toward the back of the roof of the baby’s mouth.

Do not bring the breast to the baby unless you are sure that the breast will not move away from the baby after latching and letting go of the breast. If the breast does move, the risk of nipple pain and damage is increased.

5) Watch for the baby to start sucking

Ensure that the baby has a good latch as breastfeeding begins. Expect the baby to remain latched throughout most of the feed.

6) Repeat if the baby hasn’t latched the first time

If the baby doesn’t latch within a few seconds so that you feel suction and calmly start sucking, take the nipple out and try again.

C) Other ways to help the baby latch

1) Timing

Some mothers who have difficulty latching the baby are struggling with the timing of latching. Timing is important as:

  • The nipple and areola need to be in the right place at the right time.
  • The baby needs to know when to turn on the suction.

a) The flipple technique

One technique, called flip the nipple or flipple, helps with timing. To use a flipple technique, follow these steps:

  1. Position the baby at the breast in either the cross-cradle or the under-arm hold.
  2. Use the sandwich technique to re-shape the breast and make the nipple root softer.
  3. Tip the breast by rotating the hand holding it so that your thumb moves towards your chest and your pointer finger away from it.
  4. The nipple should be in front of the top lip and pointing up towards the baby’s nose.
  5. While bringing the baby towards you, slide the nipple down the baby’s top lip and into the mouth by returning your breast to the original position.

2) The laid-back hold

Consider the laid-back hold and allow the baby to self-latch. 

3) Latching problems

If the baby still can’t latch or stay latched after a few minutes or the baby becomes upset, look for causes of the latching problem and consider which solutions might work for you.

References

Altuntaş N, Ünsal A. Which Hand Position in Breastfeeding Is Better for Milk Intake: Palmar Grasp or Scissor Grasp? A Pilot Study. Breastfeed Med. 2019 Jul 16