Defining latching problems

What is a latching problem?

A latching problem means the baby cannot bring the nipple and nipple root into the mouth and keep it there to get milk. There are two main types of latching problems: an inability to latch and an inability to stay latched. In both cases, these babies try repeatedly and may get angry or tire and go to sleep. They lose weight or grow poorly until the problem is addressed. Other babies may become unwilling or unable to breastfeed after breastfeeding has been established. Some mothers who are breastfeeding effectively may misdiagnose the baby’s normal letting go of the breast as a latching problem.

A) Describing latching problems

It is important to know if your baby:

  • Is interested in breastfeeding but has a latching problem and is unable to latch and stay latched (latching problem).
  • Is no longer willing to latch and actively refuses to breastfeed (breast reluctance or refusal).
  • Is normal and occasionally lets go of the breast while feeding.

A latching problem means that even when using proper latching techniques and good breastfeeding holds and positioning, the baby cannot keep the nipple and nipple root in the mouth (latch) in order to breastfeed. Latching problems are most common in newborns but some older babies may change from breastfeeding effectively to being unable to do so.  

There are a number of causes and solutions for babies with latching problems. Such babies should be seen by their health-care providers and may need supplementation with appropriate milk.

The baby’s latch is often blamed for causing nipple pain and even damage. However, while babies who cannot latch may occasionally clamp onto the nipple causing nipple pain and damage, most nipple pain and damage is not caused by latching problems.

Some babies lose interest in breastfeeding and become upset when pushed to do so. 

Many babies will occasionally let go of the breast for normal reasons. They may be incorrectly assumed to have a latching problem.

B) The behaviour of babies with latching problems

Unlike babies who latch well and breastfeed effectively, babies with latching problems:

  • Repeatedly try to latch and stay latched.
  • Get angry at the breast or tire and go to sleep.
  • May clamp on the nipple as they try to latch, causing pain and superficial nipple damage.
  • May latch onto the areola causing pain and bruising.
  • Lose weight or grow very poorly and are very unhappy until given milk supplements.

The signs of a good latch are missing. Such babies will breastfeed ineffectively.

A healthy newborn baby with a latching problem can quickly become sleepy and underfed and may need urgent treatment. Babies who are premature, weak newborns, or sick may be too sleepy to latch, may not have the strength to stay latched, or may let go before they have taken in enough milk. These babies may be described as lazy; this is not accurate and may result in a delay in or failure to give treatment.

C) The timing of latching problems

Most latching problems appear during the first attempts at breastfeeding. Occasionally, they appear when the mother’s milk comes in and the breast is suddenly firmer or engorged.

Less commonly, latching difficulties may start when the breast develops a problem such as mastitis, an abscess, or other causes of hardening of the nipple root.

Latching problems can settle quickly or may never resolve. The exact timing depends on the cause and on the baby's abilities. 

D) Types of latching problems

There are two main types of latching problems:

  1. Babies who can't latch
  2. Babies who can't stay latched 

The occasional baby will show both behaviours.

Regardless of which type of latching problem a baby has, the end result is the same: The baby will not take in enough milk.

In general, babies who can’t stay latched are more likely to eventually learn to breastfeed than those who can’t latch.

1) Babies who can’t latch

Babies who can’t latch:

  • Act hungry.
  • Open their mouths wide to latch.
  • Try hard to latch but just can’t.
  • Rarely or never create a vacuum that their mothers can feel.

2) Babies who can’t stay latched

Babies who can’t stay latched:

  • Latch fairly easily when hungry.
  • Create a vacuum that their mothers feel.
  • Take three to five sucks and let go.
  • May scrunch up the forehead before letting go (scowl).
  • Repeatedly latch and let go.

E) Babies who are no longer willing to breastfeed

Some babies after a period of effective breastfeeding, will become reluctant to breastfeed or refuse to do so. There are a number of options for dealing with this. Other babies may come to prefer one breast over another.

Babies who are weaning also behave in this way.

F) Normal babies whose behaviour is mistaken for a latching problem

Normal breastfeeding babies can latch and suck effectively. If their mother has a full milk supply, they grow well. Some of their behaviours can be confused with latching problems.

1) Clicking

Many babies will click during feeds. This is common when the milk is moving quickly. 

2) Not latching or letting go of the breast after a few minutes:

Normal babies may not latch or stay latched more than a few minutes if they are not hungry. This can happen when mothers mistake certain behaviours for hunger signs or are attempting to breastfeed the baby on a schedule. Babies may also become angry in this situation.

Normal babies may let go of the breast early in the feeding because they are:

  • Struggling with a lot of milk as:
  • Choking.

3) Letting go of the breast after 5 or 10 minutes:

Normal babies sometimes let go of the breast after 5 or 10 minutes because they: