March 29, 2015
“It is better to look good than to feel good.”
Many mothers tell me that their breasts are painful and they want to know why.
“It could be the latch,” I offer.
“No, it is not the latch, the nurse/doctor/lactation consultant/my mother . . . (fill in the blank) said the latch looks great.”
The problem is that the mouth and tongue are complex and the movements are complex and can be effected by various outside factors.
Do you remember Billy Crystal as Fernando? His mantra was:
“Dahling, you look mahvelous! It is better to look good than to feel good and, Dahling, you look mahvelous!”
I believe that many health care professionals were trained to assess latch at Fernando’s Hideaway.
The latch is NOT marvelous if the mom is in pain. It is NOT marvelous if her nipples hurt, if the baby is not gaining weight, if the baby cannot maintain the latch for a feeding.
What can cause this poor latch?
There are a number of things that can make the latch un-marvelous. They can include:
- poor positioning
- birth trauma
- weak suck
What are the consequences of poor latch?
- breast infection
- low milk supply
- early weaning
- gassiness in baby
- fussy baby
- poor weight gain for baby
What can be done?
Understanding what makes a good latch. When there is a good latch both mom and baby comfortable and the baby moving milk appropriately.
Different remedies can help different challenges.
Positioning the baby close to mom is essential – the closer the baby the deeper the latch
If the baby is tongue-tied, this is where the frenulum that attaches the tongue to the floor of the mouth is too restricted, this small piece of skin can be released by surgical scissors or by laser.
This procedure is quick and can prevent a host of problems both immediately and down the road including poor weight gain, the need for orthodontia, digestive issues, premature weaning to name a few. Often when the tongue-tie is present there is also a thickened frenulum under the upper lip. This, too, should be evaluated.
If there is birth trauma healing can happen by bodywork by a practitioner skilled at working with babies.
This can include a chiropractor, a craniosacral therapist, an osteopath or a physical therapist. These folks are trained to help relieve muscle tension and to release the fascia. With birth trauma there can be misalignment in the babies oral structures. Sometimes the roof of the mouth is highly arched which can make the latch very uncomfortable as the breast tissue can be pressed into this area by the baby’s tongue. If this is the case often the baby feels tension and this makes his sucking more “chompy.”
Releasing the tension can help alleviate this pain and help to reorganize the baby.
If the baby has a weak suck there can also be therapies to help as well as suck training.
If there is a breast infection the mom can continue to nurse but she must be treated.
No matter what it is important to get the baby fed. It is also important to protect the milk supply.
When there is engorgement the mom can hand express, pump and/or nurse the baby.
When needing help with breastfeeding please do not accept that if it looks good then it is good. It should feel good and it should function appropriately.
If someone says “It looks good,” this is time to seek help by someone trained to assess the latch, inside and out.
In most cases that someone is an IBCLC – International Board Certified Lactation Consultant.