Research shows that breastfeeding is best for your baby’s brain development, immune system, and digestive health, but most mothers will tell you that the first month of breast feeding is tough (that is, if they still remember those first few sleep deprived weeks after baby is born).
Within the first weeks of breastfeeding, how well your baby latches onto your breast may present a challenge. A good latch is when your baby’s mouth takes in the whole areola (the dark part of the breast around the nipple). If your baby is not opening his or her mouth completely, reposition your baby so the mouth is right in front of the nipple. Sometimes it helps to use your right hand to direct your right breast into your baby’s mouth, while using your left arm to cradle your baby and your left hand to hold baby’s head, directing it to the nipple.
Although breastfeeding may feel uncomfortable in the beginning (your nipples will transition from soft to thick, much like a callus), a poor latch can make the experience unbearable. Sometimes this is due to the anatomy of your baby’s mouth. If your baby’s tongue is heart-shaped when she sticks out her tongue, she may have ankyloglossia (“tongue-tie”). In the picture below, notice how the tip of the tongue looks like an upside-down heart.
Ankyloglossia is caused by a little piece of tissue, known as the frenulum, that sticks the tongue to the floor of the mouth. If the frenulum extends out to the length of the tip of the tongue, it will pull the middle of the the tongue back in towards the mouth, making the tongue heart-shaped. Having an ear, nose, and throat doctor, or ENT, clip the frenulum in those first weeks of your baby’s life can make the latch more comfortable during breastfeeding.
Although being a little tongue tied will probably not cause your child any long term harm (severe ankyloglossia, can cause speech problems), clipping the frenulum can make a big difference when deciding to continue to breastfeed or not. Eventually, the frenulum does stretch out, so this is not a routinely recommended procedure unless the pain to the mother is unbearable.
At the Pediatric Center of Round Rock, we know several ENTs who will clip the frenulum in the office within your baby’s first 2 weeks of life. Please ask us about the procedure if you are concerned.
As a breastfeeding mother, your anatomy can also make a latch problematic. The most common problems are flat nipples that do not stick out for the baby to latch onto, and engorgement, a hardening of the breasts when lots of milk is produced. Nipple shields (little plastic cups that fit over the breast and have a plastic nipple) are available for flat nipples. At times, it may be difficult for your baby to suck hard enough to get milk into the nipple shield, and from the nipple shield into his or her mouth. This is a common challenge during first couple of weeks, when your baby may not be that strong yet but stick with it. Eventually your baby will get stronger and be able to pull the milk out. For many women, continued breast feeding eventually pulls the nipple out, causing a ceased need for the nipple shield. If the mother’s breast is engorged , it may also be difficult for baby to latch. When this happens, pump out some milk first so that breasts become soft before having your baby latch on.
If your baby is born prior to 38 weeks, she may also have problems maintaining the latch because she is not strong enough yet. These babies typically suck a couple of times and then fall off the breast, tired. Be patient! You may have to pump your breast milk in a bottle or use a supplemental nursing system.
If you’re having latch problems when breastfeeding, let us work with you and your baby to determine the best way to improve the experience. You can also sign up for our newborn newsletter to get monthly updates on the topics that matter to you most. We will answer all of your health questions to keep your family happy and healthy.