Breastfeeding is a natural and beneficial practice that promotes optimal health for both infants and mothers. While it is often portrayed as instinctive, many new mothers encounter challenges along the way, especially with latching. A proper latch is crucial for successful breastfeeding, ensuring that the baby gets enough milk and the mother avoids discomfort or injury. Unfortunately, latch problems are among the most common reasons women stop breastfeeding earlier than planned.
What Is a Proper Breastfeeding Latch?
A good latch means the baby takes a large portion of the areola (not just the nipple) into their mouth and is positioned in a way that allows for effective milk transfer. The baby’s lips should be flanged out, and the chin and nose should be close to the breast.
When the latch is correct:
- The baby has rhythmic sucking and swallowing patterns.
- The mother feels a tugging sensation but no pain.
- The baby’s mouth covers more of the lower areola than the upper.
- The baby’s cheeks are rounded, not sucked in.
- The baby’s jaw moves with each suck.
Common Breastfeeding Latch Problems
1. Shallow Latch
A shallow latch occurs when the baby sucks only on the nipple instead of taking a large portion of the areola into the mouth. This is the most common latch issue and often leads to sore, cracked nipples and poor milk transfer.
Causes:
- Poor positioning.
- Nipple shape (e.g., flat or inverted nipples).
- Baby’s oral anatomy (e.g., tongue tie or high palate).
- Prematurity or weak muscle tone in the infant.
Symptoms:
- Nipple pain or damage.
- Clicking or smacking sounds during feeding.
- Frequent, short feedings.
- Poor weight gain in baby.
- Baby seems unsatisfied after feeding.
Solutions:
- Adjust the baby’s position (e.g., tummy-to-tummy alignment).
- Try different breastfeeding positions (e.g., football hold, laid-back nursing).
- Use breast compression to increase milk flow and keep the baby engaged.
- Seek evaluation for anatomical issues like tongue or lip tie.
- Consult a lactation consultant for hands-on help.
2. Painful Latch
Pain during breastfeeding is a strong indicator of an improper latch, even if it looks okay from the outside. Pain that persists beyond the initial seconds of latch-on is not normal and should be addressed.
Causes:
- Shallow latch.
- Tongue or lip tie.
- Engorgement making the breast hard to latch onto.
- Infection or nipple damage.
- Thrush (a yeast infection on the nipples and baby’s mouth).
Symptoms:
- Sharp, stabbing, or burning pain during or after feeds.
- Cracked, bleeding, or scabbed nipples.
- Baby pulling off frequently.
- Signs of oral thrush in baby (white patches in the mouth).
Solutions:
- Correct the latch by repositioning.
- Treat underlying causes like thrush or mastitis.
- Apply purified lanolin or hydrogel pads to heal nipples.
- Use a nipple shield under supervision if necessary.
- Get help from a lactation consultant.
3. Clicking Sounds While Feeding
Clicking or smacking noises usually indicate a poor seal between the baby’s mouth and the breast, often due to a shallow latch or trouble maintaining suction.
Causes:
- Poor latch.
- Fast milk let-down.
- Tongue tie or other oral issues.
- Nipple slipping out of baby’s mouth.
Symptoms:
- Frequent unlatching.
- Gas, fussiness, or colic symptoms.
- Milk leaking from the sides of the mouth.
- Poor weight gain.
Solutions:
- Ensure baby’s mouth is wide open before latching.
- Burp baby frequently.
- Recline slightly during feeding to slow milk flow.
- Have baby evaluated for tongue-tie or muscle tone issues.
4. Nipple Confusion
Introducing bottles or pacifiers too early can lead to nipple confusion, making it difficult for babies to latch onto the breast properly. The sucking mechanism for bottle-feeding is different, and some babies struggle to switch between the two.
Causes:
- Early introduction of bottles or pacifiers (especially before breastfeeding is established).
Symptoms:
- Baby refusing the breast.
- Inconsistent or shallow latch.
- Fussiness at the breast.
Solutions:
- Avoid bottles and pacifiers until breastfeeding is well-established (usually around 4–6 weeks).
- Use paced bottle-feeding techniques.
- Offer the breast frequently and calmly.
- Consider using a supplemental nursing system (SNS) if necessary.
5. Baby Refuses to Latch
Some babies may outright refuse to latch, leading to maternal distress and feeding complications. This may happen suddenly (nursing strike) or be a persistent issue from birth.
Causes:
- Traumatic birth experiences or separation after birth.
- Use of formula or bottles.
- Pain (e.g., due to reflux, teething, or ear infections).
- Overstimulation or distractions.
- Negative past feeding experiences.
Symptoms:
- Baby crying or arching back at the breast.
- Turning head away when offered.
- Inconsistent feeding patterns.
Solutions:
- Skin-to-skin contact to encourage feeding instincts.
- Offer breast during sleepy times.
- Feed in a calm, low-stimulation environment.
- Try feeding in motion (rocking, walking).
- Pump milk to maintain supply and offer expressed milk while resolving latch issues.
6. Flat or Inverted Nipples
Flat or inverted nipples can make it harder for babies to latch deeply because there isn’t as much protrusion for them to grasp.
Causes:
- Natural anatomy.
- Edema or engorgement making nipples less pliable.
Symptoms:
- Difficulty achieving deep latch.
- Baby slipping off nipple.
- Frequent feedings with poor milk transfer.
Solutions:
- Stimulate nipples before feeding (e.g., rolling between fingers or using cold compress).
- Use nipple shields (under guidance).
- Try a breast pump briefly before feeding to draw out nipple.
- Work with a lactation consultant.
7. Overactive Let-down
An overactive or forceful let-down can cause milk to eject too quickly, making it hard for the baby to latch or stay latched.
Causes:
- Oversupply of milk.
- Hormonal influences.
Symptoms:
- Baby coughs, chokes, or gulps milk.
- Pulling off the breast during let-down.
- Gassy, fussy baby.
- Breast leaking excessively.
Solutions:
- Nurse in a laid-back or side-lying position to slow milk flow.
- Let the first let-down spray into a cloth before latching the baby.
- Burp frequently and feed from one breast per session.
- Block feeding to manage oversupply (under professional guidance).
Tips for Preventing and Managing Latch Problems
1. Start Right from Birth
- Skin-to-skin contact immediately after birth helps stimulate feeding cues.
- Begin breastfeeding within the first hour.
- Avoid artificial nipples or supplements unless medically necessary.
2. Watch for Early Hunger Cues
- Rooting.
- Hands to mouth.
- Sucking motions. Responding early can make latching easier and avoid frantic attempts later.
3. Find a Comfortable Position
Experiment with various positions:
- Cross-cradle hold.
- Football hold.
- Side-lying.
- Laid-back breastfeeding.
Comfort for both mom and baby is key.
4. Get Professional Help Early
Lactation consultants (IBCLCs) are trained to spot and correct latch issues. Many hospitals offer this service, and ongoing help is available in communities and online.
5. Join Support Groups
Connect with other breastfeeding mothers. Peer support can offer reassurance, practical tips, and encouragement.
When to Seek Professional Help
If any of the following occur, it’s important to seek help:
- Nipple pain that doesn’t improve.
- Poor weight gain in baby.
- Frequent blocked ducts or mastitis.
- Baby refusing to latch over multiple feeds.
- Concerns about milk supply.
Don’t hesitate to contact a pediatrician or lactation consultant. Breastfeeding is a learned skill for both mother and baby, and early intervention can make a big difference.
Conclusion
Breastfeeding, while natural, can present various latch challenges that may affect both the baby’s nutrition and the mother’s comfort. Understanding common latch problems, their signs, and solutions can empower mothers to persevere through difficulties and establish a successful breastfeeding journey. With the right knowledge, support, and timely professional help, most latch issues can be corrected, ensuring a positive and nourishing experience for both mother and baby.