By: Janaki Costello, Molly Brannigan, Paula Santi, IBCLCs East Bay Lactation Associates
Most expecting mamas in the bay area look forward to breastfeeding their babies, some with great excitement, some with some concerns about how it will go and if it will work out for them.
In most cases the baby takes to the breast as nature intended, with enthusiasm and innate ability. Occasionally however, a new mama has trouble getting her baby to attach to the breast. This situation is so frustrating and difficult for the new mama and her family. Often she has no idea why her baby is not breastfeeding. She may receive all kinds of conflicting advice about what to do.
At East Bay Lactation Associates, we have worked with many new mothers who are experiencing all sorts of breastfeeding challenges including the non-latching baby. Our first action is to assess the situation to see if we can find out WHY the baby is not latching. It can have to do with many complicated factors including oral anatomy issues like tongue tie, difficult birth, the “fit” between mom’s nipple and baby’s mouth, maternal medications, baby being forced onto the breast or held in such a way that he is unable to move his head or open widely, deep suctioning after birth, etc.
It is vitally important to stimulate and maintain milk supply if baby is not latching! Many moms find that hand expression and a hospital grade rental pump works best for this early initiation and we have many suggestions for pumping and increasing milk supply.
If we find something that can be changed, such as positioning, or general management, of course we will start with that. The following are some general guidelines that we have seen work well and will keep mama and baby close without becoming overly frustrated.
- Start with calm baby.
- Take some slow deep breaths, close your eyes
- Get comfortable, leaning back, feet up
- Place your baby Skin-on-skin on your chest. Baby should not be starving. Sometimes it’s helpful to feed baby some milk first. Hungry babies cannot learn!
- Hand express first and have a little milk available to spoon into baby’s mouth, put on your own nipple or a nipple shield to entice baby with instant reward
- Learn and observe feeding cues – don’t make baby wait
- Be available! Offer the breast often. Try : different positions, latching while moving (walking, rocking, swaying, bouncing on birth ball) in a warm bath, while baby is drowsy (waking or just falling asleep) , darkened room, no distractions
- Baby-led latching works best!
- No forcing, especially no holding baby’s head, short sessions/limit frustration
- Allow baby to search for breast, you can help without any forceful movements
- Patience – Learning to breastfeed is often two steps forward, one back
- Time and lots of “kangaroo care” skin on skin carrying, holding, bathing
- Carry baby skin-on-skin in a sling, or other carrier in between latching attempts
- Keep sessions short and sweet!! Be available at any moment to offer but forcing can result in an aversion and stress so resist the temptation to be at all forceful
- If baby latches speak softly to baby, verbal reinforcement
- Acknowledge the emotional frustration/sadness/confusion
- Believe! It IS possible for any baby of any age to begin breastfeeding! Be persistent
- Your baby does not hate breastfeeding or you – when a baby is not breastfeeding
- there always is a reason – even if we have not yet discovered what it is.
The only rules:
Feed the baby – a baby who is taking in enough calories will be better able to learn
Maintain supply – make sure your pump is adequately draining your breasts, consider renting a hospital grade pump because the higher the supply the easier it will be for baby to get the milk.
Babies cannot tell time or read a calendar. Often enticing a baby to breast and teaching baby to breastfeed well can take quite a bit of time. This is when the quality of patience is so important. Having continual support from knowledgeable lactation consultants can be the difference between quitting and facilitating a smooth breastfeeding relationship.
Please do not hesitate to ask for help if you have any breastfeeding difficulties!
* For more ideas see: http://kellymom.com/bf/concerns/child/back-to-breast/ – basics
Janaki Costello, Molly Brannigan, Paula Santi, IBCLCs East Bay Lactation Associates
www.eastbaylactationassociates.com (510) 525-1155