With Rebecca Buffum Taylor and Katie
Cameron
(Continued
from the last article. See Older Posts)
How To Get A Good Breastfeeding Latch
A variety of factors can affect latch quality,
including positioning and timing. Some things, such as nipple shape, may be
beyond your control. However, some strategies can help promote a better latch.
Choose the right position. Breastfeeding
positions affect the quality of the latch, but what works for some parents and
babies might not be ideal for others. If latching is a struggle in one
position, try a few others until you find a
comfortable option.
Position your baby facing you so that your baby
is comfortable and doesn't have to twist their neck to
feed. With one hand, cup your
breast and gently stroke your
baby's lower lip with your nipple. Your baby's instinctive reflex will be to
open the mouth wide. With your hand supporting your baby's neck, bring the
mouth closer around your nipple, trying to center your nipple in the mouth
above the tongue.
Additional tips include:
- Try a nipple
shield. If you have flat or inverted
nipples, it might be hard to secure a proper latch. A nipple shield may
help by giving a clearer shape. It could also make breastfeeding more
comfortable if you’re dealing with cracked nipples or other sources of
pain.
- Wait until your
baby’s mouth is open wide. You may have a
shallow latch if your baby’s mouth doesn’t open wide enough. It needs to
cover both the nipple and a large part of breast tissue. Encourage this by
gently placing your nipple against your baby’s lips.
- Don’t be afraid
to gently unlatch and try again if
you struggle to get the timing right at first. You can do this by putting
a finger into your baby’s mouth and softly breaking the suction.
- Check for
tongue-ties. Also known as ankyloglossia,
tongue-tie is a condition that happens when the cord that attaches the
tongue and the bottom of the mouth is unusually tight. It happens in up to
11% of newborns and can limit tongue mobility, leading to a form of
breastfeeding compression, which can be painful for new parents and make
it hard for a baby to
gain weight in the crucial first few days. A procedure called a
tongue-tie revision can correct the problem.
You'll know your baby is “latched on” correctly
when both lips are pursed outward around your nipple. Your infant should have your entire
nipple and most of the areola, which is the darker skin around your nipple, in
their mouth. While you may feel a slight tingling or tugging, nursing
shouldn't be painful. If your baby isn't latched on correctly and nursing
with a smooth, comfortable rhythm, gently nudge your pinky between your baby's
gums to break the suction, remove your nipple, and try again. Good “latching
on” helps
prevent sore nipples.
Pumping And Hand Expressing
There are many
situations in which you may need to express that breast milk yourself
instead of letting your baby nurse. These situations may arise when:
- Your baby is too premature to breastfeed
- Your baby is in the neonatal intensive
care unit (NICU) and you're unable to stay with them
- Your baby is ill
- Your baby is teething
- Your baby has latching difficulties
- Your baby has a condition such as a tongue
tie or cleft palate
- You're away from your baby for a long
period (like going back to work)
- You’ve consumed a high amount of alcohol
or recreational drugs or taken a medication that's not safe for your baby
Going too long without emptying your milk can
lead to engorgement, or overly full breasts. A painful condition on its own,
engorgement can also lead to complications such as clogged milk ducts or mastitis,
in which the milk ducts become inflamed or infected. Hand expressing or pumping
can help you empty your milk.
What Does Hand Expression Of Breast Milk Mean?
Hand expression is a type of massage to the
breasts that releases milk. Parents
choose to hand express for many reasons, including:
- It’s a way to express milk when the baby
cannot nurse. This allows you to collect milk for later.
- It may allow you to avoid engorgement.
Engorgement can be painful and cause leaking or clogged ducts.
- It requires less equipment
than pumping. Breast pumps often require a whole bag of equipment, with the
machine, the tubes, the flanges, and the bottles. This can be
difficult or annoying to carry around.
- You can hand express milk in more places
than you can pump. Most pumps require electricity. If you’re in a
situation where you don’t have electricity available to you, you won’t be
able to pump. Additionally, if you’re out and about and didn’t bring the pump
with you, you still have the option of hand expressing.
- The skin-to-skin
contact offered by hand expression encourages the milk letdown reflex.
The milk letdown reflex is what causes your milk to start flowing and may
be easier to trigger with hand expression than with a pump.
- You may get more milk with hand expression
than with a pump.
- It’s free. In many cases, insurance will
cover your breast pump. But if you don’t have insurance, or for some
reason your pump is unusable, hand expression will save you from having to
spend money on a pump.
To Prepare For Hand Expressing Milk:
- Wash your hands to avoid contaminating
your milk.
- Find a clean container to collect the
milk. If you’re expressing colostrum, the thick, nutritious milk released
immediately after birth, you may only need a teaspoon.
- Relax and get comfortable. If you’re
tense, it will be more difficult to produce milk.
- To encourage letdown, it may help to have
your baby nearby. If that’s not an option, try looking at photos of your
baby or keeping a piece of clothing near you that smells like your baby.
- Gently massage your breasts to encourage
letdown.
When you're ready, hold your breast with your
hand in a C-shape. Your thumb should be on the underside of your breast, and
your fingers along the top. Your fingers and thumb should rest near, but not
on, the areola. Supporting your breast with your hand, apply pressure to the
milk ducts by pushing toward your chest. Compress your breast between your
fingers and your thumb to encourage the milk toward the nipple. Repeat the
pressure and compression rhythmically until milk flow stops. Rotate your hand
and repeat the movement until milk flow stops again.
Continue around your breast until all areas of
the breast are drained and soft. Hand expression of milk can take 20 or 30
minutes at a time.
When Does Pumping Help?
Breast pumps can be cumbersome. They require a
lot of parts and a supply of electricity. It’s not always possible to carry
those parts around with you, and you may not be in a situation where you have
consistent access to electricity. In that case, hand expression likely wins out
over pumping. Pumps can also be noisy and uncomfortable to use.
But there are reasons some parents may prefer a
pump to hand expression. Some pumps are hands-free, allowing you to do other
things while pumping, such as working, tending to other children, or
entertaining yourself with a book or your phone.
Additionally, pumping can allow you to store
milk if you're going to be away from your baby. This can offer you more
independence and allow other caregivers to help feed your baby…
(To be concluded in the next article. See
Newer Posts.)
Rebecca Buffum Taylor and Katie Cameron
work with WebMD
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