One of the biggest reasons people quit breast/chestfeeding early is because of nipple pain. A good or bad latch can literally make or break the breast/chestfeeding relationship. There are many different reasons for a painful latch, and some need more intervention than others. But we always start with positioning.
Positioning of the lactating parent and baby can make a big difference in the way that the latch feels. If positioning does not help to create a better latch and a more comfortable feed, make sure you are working with an IBCLC who is trained in oral assessments in case there is more going on.
Keys to a good latch
Start by getting yourself into a comfortable position. It doesn't matter what position you prefer to feed in as long as you and baby are comfortable and baby is transferring milk appropriately. Have pillows close by and make sure that you are relaxed when feeding. Most parents tend to hold a l0t of tension in their shoulders, upper back and neck when feeding. That tension over time will create pain.
Get baby to the height of your breast before latching. You can use any pillow. It does not need to be specific for breast/chestfeeding.
Get to baby in a quiet-alert state. A crying baby is a baby who is overly hungry and who will likely be a hard to latch baby.
Uncover baby. Take off any swaddles, blankets restricting the hands and any mittens. Babies need their hands to help guide them to eat. Think about trying to eat without your hands. It would be very hard.
Start baby nose to nipple or just below the breast. THIS IS THE BIGGEST MISTAKE I SEE. You want baby to reach up, and extend their neck to latch on. Not go chin to chest. When we drink water, we tilt our head backwards to elongate our neck. Babies need to do this as well. Starting just under the breast will help baby to reach with the head and neck to latch on.
Wait for a wide open mouth. Think about taking a bite out of an apple, that's what you want baby to look like. Taking your nipple and stroking baby's upper lip will stimulate them to open their mouth. Be patient and wait for that wide open mouth.
Bring baby into your breast/chest (not your breast/chest to them) leading with the chin. The chin should anchor to the breast first which helps to open the mouth a bit wider and the rest of the mouth goes up and over the nipple and areola.
Take a look at baby. Is baby's head, neck and hips all in one straight line? Is baby's neck extended or are they chin to chest? Is the latch asymmetric meaning baby will have more of the bottom than the top of the areola in their mouth? Are your shoulders and back relaxed and not tense? And most importantly, how does it feel? It shouldn't be painful but should feel more like a tugging sensation.
If you have tried positioning changes and nothing seems to be helping, it could be tethered oral tissue or tension throughout the body causing pain while feeding. Breast/chestfeeding shouldn't be painful and shouldn't cause nipple damage. If you are dealing with any of these things, get help because it can make or break your feeding journey.
Kelsey RN, BSN, IBCLC
Love At First Latch