Originally published on March 25, 2019
To prepare students in the likely event that they treat a patient who is breastfeeding (or contemplating breastfeeding), the RVU OBGYN Club hosted a three-part Breastfeeding Basics series. The second presentation, led by Katie Halverstadt, RN, International Board Certified Lactation Consultant and Chair of the Colorado Breastfeeding Coalition, focused on common issues experienced during breastfeeding and their correlation to latching and positioning.
While a mother’s body begins to prepare for breastfeeding in the early stages of pregnancy, establishing a steady milk supply requires coordination. It is encouraged to start breastfeeding shortly after delivery, and to do so with as much skin-to-skin contact as often as possible, especially in the first three days. The benefits of skin-to-skin contact include a better latch, a more comfortable and warm baby, and increased milk production. Gravity can also be used to help the baby latch. This can be done by having the mother recline back while breastfeeding. Doing so keeps pressure off of the pelvis and abdomen, which will be sore after a natural or Cesarean birth. The baby should be able to latch on with ease if the delivery was without complications.
If a mother is experiencing latching issues, there are several steps that can be taken to assist baby and ensure a steady milk supply. The baby should always be positioned so that ear, shoulder, and hip are in alignment. This will relieve tension from the baby’s neck and help them latch and swallow properly. A shallow latch can result in pain for the mother such as pinching or flattening of the nipple. Mothers are also encouraged to support their baby’s shoulder so the baby has more freedom to move their head. A variety of positions can also be used to alleviate painful (or shallow) latching, including the cradle, cross-cradle, U-Hold (two-handed hold), the football hold (tucked in the arm), and the standing football hold.
As neck strength increases, latching will become easier for the baby. A good latch will be characterized by a wide open mouth, more of the areola above the baby’s lip (as opposed to below), ear and jaw moving, strong pull, actively suckling and swallowing, and an audible sound. An ineffective latch will be recognizable due to a clicking sound, a fussier baby, and the baby being too far away (nipple not completely in the mouth). It should be noted that a “colicky” baby will cry for at least three hours straight and three times a day, and could be a result of potential allergies or bad bacteria in the gut. It is recommended that mothers keep a food diary to track potential food allergies.
The event ended with a Q&A session with questions ranging on the effectiveness of breastfeeding as a contraceptive to latching issues such as tongue tie.
Check out the World Health Organizations guidelines on breastfeeding here.