As a lactation specialist, there are a number of elements that I look for, and tell parents about, in order to identify whether a baby has a good latch or an incorrect latch that needs to be adjusted. Here are the things I look for during every lactation consult in order to ensure mom and baby are off to a great start!
1. Does your baby have proper body alignment? Your baby's ear, shoulder and hip should all be aligned. This can be achieved by ensuring your baby is always "belly to belly", meaning your baby's belly is facing your belly. One of the most common mistakes we make as breastfeeding mothers make is allowing our baby's torsos to turn away from us, and thus only the head is turned towards the breast. This does not allow for optimal transfer of milk from you to your baby. An analogy I often us is: think of it as an adult drink liquid out of a straw - it is much easier to drink out of a straw if it directly in front of you, as opposed to off to one side and you having to turn just your head to drink out of it. It's the same for your baby!
2. Does your baby open his mouth wide and tilt his head back prior to latching onto the nipple? It is important for your baby to have this "gape response" in order to ensure a proper latch. This wide latch allows for optimal transfer of milk and eliminates pain and damage to your nipple(s). Your baby will naturally open his mouth and tilt his head back prior to latching, so it is also important to ensure that his NOSE is aligned with your nipple when initiating a feeding at the breast. Aligning the nose with the nipple will ensure that when your baby tilts his head back to latch on to the breast, your nipple enters his mouth so that more of your nipple and areola are in the top half of your baby's mouth. This deep latch, allows him to draw your nipple along the tongue, toward the back of the mouth/throat, and up along the soft palate of his mouth to maximize transfer of milk and eliminate nipple damage caused by a shallow latch and your nipple being compressed against the hard palate of your baby's mouth.
3. Are your baby's lips flanged out and does she maintain a wide latch throughout the feeding? It is important for your baby to have her top and bottom lips flanged out (i.e. "fish lips"), in order to create the necessarily negative pressure that will allow your nipple to be drawn into your baby's mouth and allow optimal transfer of milk. It is also important to ensure that she maintains the wide latch that was achieved by waiting for your baby to open her mouth wide prior to bringing her head to the breast. The easiest way to see if your baby is maintaining a deep latch is to simply press down on your breast near the corner of your baby's mouth to see if the angle at the corner of her mouth is a wide angle.
4. Does your baby's jaw move in a rocker motion while sucking? If you watch your baby's jaw line while he is breastfeeding, it typically only moves in two ways; either up and done (like a piston and/or biting), or back and forth (like a rocker). The optimal motion of your baby's jaw during breastfeeding is a rocker motion, as this is an indication of a deep latch. The piston/biting motion is indicative of a shallow latch, and thus can result in pain and damage to the nipple.
5. Can you hear your baby swallowing throughout the feeding? Hearing swallowing is the best way to know that your baby is getting breastmilk (and it also a very gratifying sound to hear as a breastfeeding mother!). When your milk is fully in, you should hear swallows often, either every suck or every other suck. When your baby swallows, it sounds like they are pushing out a small push of air from their nose/throat. It can be difficult to hear to the untrained ear, but if you sit in a quiet room during a feeding, you should be able to recognize this sound after a few good feedings.
The last thing that I tell all breastfeeding mothers is that it's ok to break the seal if your baby has a bad latch, and in fact, I encourage this! If you are experiencing pain throughout the feeding or in the middle of a feeding that is going well start to feel pain or notice a change in your baby's latch, then break the seal by placing your finger in your baby's mouth. Then re-latch the baby and ensure she has a good latch by using the points above. And as always, whether you are off to a good start or a bumpy start, reach out to a lactation specialist near you! And for all you Massachusetts mama's feel free to reach out to us by clicking here, to schedule your in-home appointment with one of our lactation specialists.