My newborn baby does not latch on to the breast and it is exasperating
Newborns are born “programmed” to suck; human beings are mammals. Most babies have no difficulty latching onto their mother’s breast and expressing milk.
However, some babies have a hard time latching on: they refuse the breast, they can’t latch on , or even if they do latch on, they don’t latch on effectively and can’t get the milk they need. What do we do in these cases? It has a solution?
The importance of skin-to-skin contact
The benefits of doing skin to skin immediately after childbirth have already been well studied . This first hour after childbirth is known as the golden hour (or “ golden hour ”). Staying in skin-to-skin contact with their mother after birth helps newborns adapt to life outside the womb: they better regulate their temperature, decrease their caloric expenditure and improve their oxygenation.
In addition, it favors the affective mother/child bond and the release of oxytocin, which in turn favors the uterus to contract and the ejection of colostrum. As for breastfeeding , skin-to-skin contact after childbirth increases the chances of success .
In this first hour (some experts extend this period to the first two hours of life), the newborn is able to locate its mother’s breast, crawl to reach it and latch on; It is what is known as spontaneous coupling . They take an average of 40 minutes to do.
Some babies, however, don’t quite make it. In this case, it is convenient that a professional trained in breastfeeding help us to make a directed latch: we place the baby close to the nipple (brushing the nipple against the nose and philtrum) and help him to latch. The vast majority of babies take their mother’s breast in these first moments in one way or another.
Why won’t my baby latch on?
As we have seen, most newborns are capable of latching onto their mother’s breast after delivery. However, a few babies do not. In other cases, babies who latched on without a problem right after birth are later unable to latch on again. In what cases does that happen? Why it happens?
- Mother-child separation . The usual thing in most hospital centers is that mother and child do skin to skin after childbirth. In the case of caesarean sections, more and more centers are also doing skin-to-skin. However, sometimes there are circumstances that make it necessary to separate the mother and the child for a while: delivery complications, illness of the mother or the baby, very premature or low birth weight babies… In these cases, it could be more difficult to then latch on to the chest.
- “Sleepy” babies . After those first two hours after delivery, in which the newborn is awake and active and latches easily to the breast, comes the sleep phase known as physiological lethargy of recovery from childbirth , in which the newborn sleeps for a long period of time, some 8 to 12 hours.It is important here that you continue to have easy access to the breast so that you can latch on when needed.In the following days, babies often wake up every so often to nurse, It is common for them to demand between 8 and 12 feedings a day, however, there are some more sleepy babies who wake up less than they need and, depending on the circumstances of each one (premature or term baby, birth weight, weight loss…), the pediatrician may recommend waking him up from time to time to eat. In addition to placing him close to the breast so that the smell stimulates him, it may be helpful to undress him, change his diaper, and/or gently massage his back or the bottoms of his feet .
- Anatomical problems to hook . The orofacial anatomy of the newborn is designed to suck without difficulty. Thus, for example, they have a tongue that occupies their entire mouth and is capable of undulating movements to pump milk from the ducts to the nipple, a flat nose that allows them to breathe while attached to their mother’s breast, little lumps on the inner part of the lips that facilitate attachment to the breast and fat pads on the cheeks that help suction.
However, some babies have different anatomical features that make breastfeeding difficult . Here we find ankyloglossia (tongue “anchored” by a too short lingual frenulum), retrognathia (retracted lower jaw) or malformations such as cleft palate and cleft lip . Premature, very low birth weight, and hypotonic babies also find it more difficult to breastfeed.
- Problems in the mother. In other cases, the baby cannot latch onto the mother’s breast because it is too full ( engorgement ). In this case, the softening reverse pressure is very useful because it displaces the edema and leaves the nipple softer, allowing the baby to latch on better.
Contrary to popular belief, flat or inverted nipples do not have to be a problem for breastfeeding . Only true inverted nipples (those in which the fibers that protrude the nipple are absent) may not make breastfeeding possible.
How to encourage the baby to latch on to the breast
1. Golden hour, skin to skin after childbirth
How could it be otherwise, this is our number 1. This helps to start breastfeeding early, increases the chances of having a correct latch and engorgement pain is less frequent. Check out more interesting articles on our site.
2. Skin to skin at any other time
Outside of the immediate postpartum period, doing skin to skin with our baby also favors bonding. It has to be real skin to skin: mother without a shirt or bra, baby in a diaper. The smell of the mother, the smell of milk and a substance released by the Montgomery glands (those lumps in the areola) favor the baby’s latching. It can also be useful to place ourselves in the biological rearing position (mother semi-sitting with the baby’s belly on her) to allow the baby to crawl onto the breast and latch on spontaneously.
3. Avoid teats
The use of pacifiers or teats can, in some cases, lead to teat-nipple confusion . And it is that the breast is held in a very different way to how the pacifier is grabbed or sucked from a bottle. Some of the babies with latching difficulties should be given supplements (which can be expressed breast milk or, if not possible, starter formula). In these cases, the supplement can be given with a syringe, finger feeding, a cup or, if it is given with a bottle, using the Kassig technique , to prevent it from interfering with sucking at the breast.
As we have mentioned, sometimes the baby does not latch on its own and we have to help it. To do this, we will brush your nose and upper lip with the nipple to trigger the search reflex . In some cases, especially if the breast is very large, we can hold it in a C shape and gently compress it, offering it as a sandwich. Expressing a few drops of milk manually can also help. When the baby opens his mouth wide, we will bring him closer to the chest, trying to get him to grab as much of the areola as possible.
5. Find the most suitable posture
Some babies latch on better in one position than another. In the case of babies with a frenulum or retrognathia, for example, the piggyback position is very useful. Some babies with ankyloglossia, however, will need to have their frenulum cut (frenotomy) to achieve good latch-on and milk expression. The mother also plays a very important role and she must find the position that is most comfortable for her. Thus, for example, after a caesarean section, the lying position may be the most suitable for breastfeeding the first few days.
6. Nipple shields?
In general, they are used much more than they should be, but in specific cases and almost always temporarily, they can be useful . Some babies with frenulum , premature babies or specific cases of flat or inverted nipples may benefit from using them. They can also help us in those cases in which the baby has been separated from the mother and has been bottle-fed for some time.
And finally, I want to emphasize the importance of knowing how to ask for help. Breastfeeding is not always easy and health professionals are increasingly involved with it. If you have difficulties for your baby to latch on, do not hesitate to consult because in most cases it can be solved.