In breastfeeding, the latch is the moment everything comes together: Your baby takes a big mouthful of your nipple and areola (or "latches on"), begins to suck, and draws out your milk. When your baby has established a good latch, your nipple soreness is minimized and your little one gets the nourishment he needs. How do you pull all that off? First and most important, have faith in yourself and your baby. "Babies are designed to breastfeed," says Emily Pease, R.N., international board certified lactation consultant (IBCLC), of Swedish Hospital's Breastfeeding Center in Seattle. "They are born with instincts that help them find Mom's breast and latch on often with very little assistance. And if problems do come up, there are lots of ways to troubleshoot." Here are more steps to get a good latch right from the start.
Step one: Do your homework. Before your baby arrives, take a breastfeeding class -- many hospitals and birthing centers offer them -- or go to a La Leche League International meeting. At prenatal breastfeeding classes, instructors demonstrate latching with videos or with dolls, so you can get more comfortable with the process. Connecting with other moms and new moms-to-be can be an invaluable source of support should you have questions or problems when your turn arrives.
Step two: Get comfortable. Find a relaxed position that you can stay in for a while. Some experts encourage moms to breastfeed in a reclined position (usually about 45 degrees, though do what feels good for you), especially at the beginning. "It's usually much more comfortable for the mom," Pease explains. Also, when you're lying back, gravity helps support your baby so you don't have to do all the work. And it's an easier position for your baby to use her hands, lift and turn her head, and bury her chin into the breast, all helpful things for her to do when she's latching on. It's your partner's job to hold your baby while you're getting settled, so pay attention to where you might need an extra pillow or two, and make sure your water bottle's full.
Step three: Start breastfeeding as soon as possible after your baby is born. The earlier you start breastfeeding, the more likely you'll be to tap into your baby's innate abilities to latch on, making the process easier for both of you, as well as keeping your milk supply strong. "Right from the very beginning, a baby's natural reflex is to crawl up to Mommy's breast on his own and start nursing," says Agnes Pedicino, IBCLC, and a childbirth educator based in New York City. "When you put your baby's bare skin on your bare skin, you help those reflexes kick in." Even if you've had to be separated from your baby for a little while after birth, skin-to-skin contact, plus your smell and touch, can bring him right back to nuzzling and rooting around looking for your nipple.
Step four: Set your baby up to nurse properly. Begin by putting your baby tummy down on your bare chest, and tummy in little else than her diaper, with her cheeks and chin touching your breasts. Some moms find it most comfortable to place their babies horizontally across their chests, but do whatever works for you. Placing your hand on your baby's upper back and neck might help steady her. You can encourage her interest in your nipple and make her open wide by expressing a little colostrum (your first milk): Rub your thumb and finger back and forth across your nipple, gently compressing your areola to make some come out. Ideally, your baby's bottom lip will be near or on the base of your areola with her nose opposite your nipple. When she smells the colostrum, she'll bury her chin into your breast, open her mouth, and latch on. "Your mammary glands are located behind the areola," Pedicino says. "You want your baby's mouth covering most of the bottom of your areola and some of the top -- not just your nipple -- so those glands are stimulated when she sucks, and produce milk." If your breasts are large or your baby's mouth is small, you can make it easier for her to latch if you compress your breast gently into a sort of nipple sandwich: Cup your breast in a U-hold so your fingers are parallel to your baby's lips and gently squeeze, as you would if you were pressing down on a big sandwich you're about to bite into. You'll be making your breast into a smaller "bite" for your baby.
Step five: Know the signs of a good latch. Your baby is latching well if you feel a pulling or tugging sensation on your breast and he is getting milk. How to tell if your baby is swallowing? His temple and lower jaw move rhythmically and you hear a breathy aah occasionally, which is your baby exhaling after he swallows. (Keep in mind that before your milk comes in, your baby won't be swallowing all that often because the volume of colostrum isn't high.) Ideally, your baby's lips will be flanged out -- like a fish or an open flower -- around your nipple and areola, not tucked under, which may make your nipples sore.
Step six: Be on the lookout for signs of trouble. It's common for new moms to feel a little soreness or tenderness with breastfeeding, especially in the very beginning. "But you shouldn't feel pinching or biting, and any soreness shouldn't last the entire feeding," Pease says. "If it does, it means there's something going on that we need to explore." Pay attention to how your nipple looks when your baby detaches. "If it's compressed, cracked, or bleeding, that's not normal," Pedicino says. If you notice any of these things or feel a lot of pain, or if something seems off for your baby, reach out to a lactation consultant, talk to your doctor or pediatrician, or find a support group. Some issues can interfere with your baby's nursing abilities, and an expert can help. "Maybe your baby is biting or has a tight jaw, or perhaps you have flat or inverted nipples," Pease says. "There are things we can do to help all that. Breastfeeding is normal; it's what babies do. So if there's a problem, let's figure out how to fix it!"
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