What is a perfect latch anyway?
Read Time | 6 minutes
The elusive perfect latch.
I don't know about you, but I somehow managed to successfully milk feed my child at the breast for over three years with a shitty looking latch.
We always nursed tummy to tummy, her ears-shoulders-hips in alignment, and her head tilted back slightly to allow for good extension, of course. And there never was a day that we didn't shoot for the perfect asymmetrical latch. But somehow or another, her latch always *looked* like crap.
She transferred well and thrived.
I often see the inverse of this. A parent will contact me complaining of pain with nursing, confused because the previous help they received said the latch looked perfect! Yet, for some reason the pain persists, their nipples continue to be damaged, and baby continues to struggle with weight gain, despite the *perfect* looking latch.
So what gives?
In today's post, I am going to share with you some secrets that may help you identify the reason you're experiencing pain with nursing. Yes, even if your latch looks perfect!
The first secret that nobody tells is this:
A possible reason your baby's latch is painful is that you're taking the lead.
Latching fundamentals are essential and should be the first thing to address with painful feedings. But it's necessary to understand the basics of infant feeding, starting with how babies attach (latch) onto the breast, to better assist our pain-free latching efforts.
I've written on the topic before (The Science of Latching) and it is worth checking out if you want to read a more in-depth explanation of how babies latch.
Interested in learning more about latching? Click here to get a FREE latching guide, jam-packed full of information that will help you develop a better understanding of the latching process.
In short, babies have needs that must be met to allow them easier latching on. The way we're traditionally taught to latch our babies on doesn't always align with these needs and can interfere in the latching process.
But the mission of this post is to explain why feeding is painful despite using the proper latch-on techniques.
To better understand that we need to know secret number two:
Pain with breastfeeding is often due to an issue with oral function
Proper oral function and mobility are essential for effective and painless breastfeeding. There are many reasons that feeding may be painful including pain due to compression or rubbing of your nipple in your baby's mouth and/or excessive sucking strength. In most cases, where pain is present despite proper latching technique, there's an underlying issue with function.
For example:
Typically, with painless nursing, your nipple should be drawn back into your baby's mouth to reach the area where their hard and soft palate meet. If your nipple is too far forward in their mouth, your nipple will get smashed between their tongue and hard palate causing you pain and misshaped nipples.
Another possible outcome is that your nipples become abraded, or damaged by friction, caused by the tongue rubbing the face of your nipple.
Additionally, unrelieved excessive sucking pressure during feedings can cause a decrease in blood flow in your nipple causing pain and vasospasms.
In any of these cases, it's what's going on inside of baby's mouth that's causing pain, regardless of how wide and perfect the latch looks to the outside observer.
So in which situation would we see these types of events occurring?
Here's a short list of the possibilities. Your baby may have:
A restriction in tongue mobility (such as extension, elevation, cupping, lateralization) due to tongue tie
An excessively recessed or small jaw
A tongue that is overly large
Small or absent sucking pads
A high or arched Palate
Dis-coordination managing the suck-swallow-breath process
Low or high tone
All of these things can have an impact on how your baby uses their mouths and tongue to feed, and most of these can't be assessed by looking at latch alone. A proper evaluation of pain with nursing must include a full assessment consisting of watching a feeding session and investigating all causes of feeding pain.
Another benefit of getting professional lactation help to resolve your pain with feeding is we can provide you with guidance regarding the best feeding positions for your specific situation.
That leads us to secret number three:
You may not be using the right feeding position for your baby's feeding abilities.
It may seem that there are only a handful of positions to use and that they are all created equal, but this is absolutely not the case.
I briefly covered this in 6 positions you may not know about, where I introduced six therapeutic breastfeeding positions and holds and quickly discuss in what situations these positions may be effective.
But just as it's impossible to cover all the possibilities of positions and holds in an easily digestible post for parents, it's impossible to give blanket statements about which holds will be perfect for every situation.
Another way to look at it is that just because two babies have tongue ties, the positions they need to nurse comfortably and without causing pain may differ. Parents too have different abilities and not every nursing position that may be beneficial for one family will be physically achievable by another.
The fantastic thing about breastfeeding though, is that there is no right or wrong way to do it. I encourage you to play around with finding a position that works for you and your baby. You may be surprised to discover a position that you make up on your own completely resolves your pain with nursing!
The next secret I want to share with you is meant to provide awareness not cause alarm. I realize any time I have to preface a statement, I should expect the latter to happen, but in an attempt to combat that, here's a quick reminder:
If you're exclusively human milk feeding at the breast and your baby is having the appropriate amount of wet and dirty diapers and is gaining well, this probably doesn't apply to you.
Secret number four:
Your nipple pain with nursing may be due to low supply
Nipple pain and low supply seem to perfectly exemplify the "what came first: the chicken or the egg" conundrum.
In many cases, as we discussed above, painful nursing is a result of poor breastfeeding ability, which can eventually lead to lowered supply.
But in some cases, nipple pain is a result of the low supply. In an attempt to get more from the breast, your baby may exert an intense amount of pressure to try to get milk out. This suction pressure can interfere with nipple perfusion, cutting blood flow from your nipples, resulting in a stabbing, stinging and shooting pain during and after nursing sessions.
As supply and flow volume increases, the nipple pain may subside.
An at the breast feeding devices or a small amount of human milk supplementation prior to direct nursing can help reduce the pain with nursing. At the breast feeding devices allow babies to get more milk volume faster, reducing their urge to suck so vigorously as to cause pain, and a small, pre-feed milk snack can help a super hungry baby calm down enough to feed using less sucking pressure.
Talking with your lactation professional before implementing any of these techniques can help you find the right one for your situation.
If you feel that you may be struggling with low supply, here's additional reading you may find helpful on your milk boosting & feeding journey.
Want to start investigating the cause of your low supply? Here's an easy- to- use checklist that will help you quickly identify possible influencing factors
Need help to increase your supply fast? Check out this blog post, which provides you with things you do starting today to quickly increase your supply.
Need help with flange sizing? Download this free this 17-page flange sizing guide, which outlines everything you need to know to find the best flange fit possible.
The last secret that I want to share with you may not be a secret at all, but something that is important to remember.
The perfect latch is one that is not painful and one where baby can nurse without difficulties and can transfer well.
How it looks on the outside is not as important as to what’s actually happening between your baby and the breast. My daughter had an awfully shallow looking latch, probably due in part to the elasticity of my breast tissue and how our parts came together. This situation may be the same for you if nursing is painless and your baby is transferring well to maintain your supply and grow well.
If this is not the case for you, if it’s painful or transfer is an issue, please seek assistance. Making an appointment with Mattos Lactation is easy to do and I would love to help you get closer to your goals.
If you have any questions or comments about this topic, let me know in the comments below!