Improving Latch By Improving Positioning: Troubleshooting (Part 7 of 7)

This is the seventh and last in a series of posts and videos describing how effective positioning promotes effective latching. In this video I describe how to troubleshoot and fix a painful latch by changing the baby's position.

The first step is to check the elements of an effective latch to see what is out of place:

  1. Does the baby have full tummy contact with the mother's body?
  2. Does the baby feel stable?
  3. Is the baby's head aligned with his spine, not turned or tilted to the right or left?
  4. Does the baby reach up to take the breast?
  5. Is the baby in a good drinking position with 2 finger-widths between the chin and chest?

In my experience, when latch is uncomfortable or painful, the most common problem is that the baby is not in a good drinking position and is looking down to take the breast. Often the latch can be improved without actually taking the baby off the breast. A mother can try moving her baby towards his feet an inch or so and pulling him in closer to her body from his shoulders. Moving the baby this way often shifts the position of the nipple in the baby's mouth and gets it to the roof of the baby's mouth. It can can also help the baby take more breast into his mouth.

Mothers who have been experiencing difficulty latching for days or weeks may find that improved positioning reduces their discomfort, but that the pain is not completely gone. Many mothers in this situation can tune in to the sensation they are getting and ask themselves, "is the pain I'm experiencing because my baby is damaging my nipple with this latch? Or is this latch ok and the pain I am experiencing is due to how tender my nipple is from the previous damage?"

Sometimes despite excellent positioning and a latch that looks right, a mother will still be experiencing pain with breastfeeding. The majority of sore nipples are caused by poor positioning, but there are also mothers who experience pain with breastfeeding for other reasons - tongue tie, inverted nipples, thrush, or other reasons. If improving positioning doesn't reduce or elimate the pain with latching, a lactation consultant can assess the baby's tongue, palate and suck, and help get to the bottom of why breastfeeding is painful.