The Ordinary Doula Podcast

E80: Deep latch makes all the difference in your breastfeeding journey

• Angie Rosier • Episode 80

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The deep latch is the cornerstone of successful breastfeeding, affecting everything from milk transfer to nipple comfort and baby's weight gain. Angie Rosier shares expertise from her dual role as a doula and lactation consultant, offering practical techniques to improve breastfeeding outcomes.

• Visual signs of a deep latch include pulsating movement by the baby's temple, full jaw movement, and a wide mouth opening of about 140 degrees
• Proper latch should not cause prolonged pain or nipple damage - these are signs adjustment is needed
• Keeping baby remarkably close to the breast helps maintain a deep latch
• Using a rolled blanket under mother's wrist provides support to maintain positioning
• "Threading" technique helps deepen latch by pushing more breast tissue into baby's mouth
• The "chin pull" technique can widen baby's gape while they remain latched
• Most latch problems can be improved without constant relatching, which frustrates babies
• When basic techniques don't solve issues, deeper assessment of oral anatomy may be needed
• Support is available through hospital lactation consultants and private practice consultants
• Make a connection with someone you love today - you never know what difference it will make

Please make a connection with someone you love today. You never know what that will bring.


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Show Credits

Host: Angie Rosier
Music: Michael Hicks
Photographer: Toni Walker
Episode Artwork: Nick Greenwood
Producer: Gillian Rosier Frampton
Voiceover: Ryan Parker

Speaker 1:

Welcome to the Ordinary Doula Podcast with Angie Rozier, hosted by Birth Learning, where we help prepare folks for labor and birth with expertise coming from 20 years of experience in a busy doula practice Helping thousands of people prepare for labor, providing essential knowledge and tools for positive and empowering birth experiences.

Speaker 2:

Hi, my name is Angie Rozier. I'm your host of the Ordinary Doula podcast and we're glad you could be with us today. We're doing another episode that has kind of a lactation slant on it, which can be very important. So I work not only as a birth doula, postpartum doula, but a lactation consultant as well, so I get to see people in the hospital. I work in a couple of different local hospitals, in lactation and privately as well. I love both of those roles and they are so very different from each other. So when I help people in the hospital it's sometimes within minutes after the baby's born. You know day one, day two, day three, however long they are in the hospital, get to see them at that point, help with what's going on there. And then I also have a private practice and see people in their homes after they get home, whether that baby's four days old, four weeks old. Sometimes I see babies that are two or three months old for the first time and the challenges, the things that they face, the experiences they're having are very different in both of those realms and I love both of them. So in the beginning you know we haven't, we don't know all of the challenges yet in the beginning and some challenges crop up later, some come up right away, but I would encourage you to have some resources in your back pocket so know what to do if you have questions about lactation. We have, you know, this whole new focus. As soon as that baby's born, almost everything focuses to feeding the baby. There's a lot of other things going on as far as, like, recovery from birth, taking care of mom, things like that, but the main focus oftentimes is on feeding that baby, because it's something that happens frequently, right Like every couple of hours actually.

Speaker 2:

So I want to talk today about the baby's latch. So when the latch right is how the breast matches up with, or how the mouth of the baby's mouth matches up with the breast, and what we the terminology we talk about in a latch is a deep latch. So a lot of the challenges or the successes about breastfeeding have to do with the latch. Like, how is that baby attaching to the breast? What kind of support is the baby getting in doing that? Some babies need a whole lot of support, like literally right, like head support, neck support, keeping that mouth on the nipple. Some breasts need a lot of support as far as holding them up so that the baby can stay latched. If we don't have a great latch, we could have problems. We could have transfer problems, where the baby's not getting enough as far as volume. We could have nipple or breast challenges where the mom is having damaged nipples or having a whole lot of pain that she's experiencing which, as you can imagine, creates a huge challenge if we're breastfeeding every two or three hours.

Speaker 2:

So the latch is key. It's one of the most key components of the breastfeeding relationship. That has to do with supply right, which has to do with weight gains, which has to do with, you know, a lot of things. Breastfeeding is an anatomy matchup. We're matching up the mom's anatomy, her nipple, her breast and her milk supply, which we don't maybe always know about right in the beginning how it will be, and we're matching it up with that baby's mouth, the internal and external structures of that baby's mouth, which we didn't meet until they were born right. So as we match those things up, sometimes the anatomy might cause some hurdles, but sometimes the anatomy challenges can be overcome by a good and a deep latch.

Speaker 2:

So in this episode I want to discuss what a deep latch is like. There are a couple of things you can look for, like visually you can see with your own eyes when a baby has a deep latch. There are some things you can feel, like sense on own eyes when a baby has a deep latch. There are some things you can feel, um, like sense on the breast when a baby has a deep latch and um, and then there's some small adjustments to make, and I do it all the time for people, as I'm watching them, like, oh, let's make this small adjustment so that that baby can get a deeper latch. And a lot of people you know say, yeah, breastfeeding's going pretty well, kind of hurts, or kind of this or that. I have questions about this or that where, so many times just having somebody lay eyes on whether that's in the hospital. If you have lactation consultants available, I encourage you to talk to them. Start off strong, start off doing things as well as you can to avoid some problems down the road. But sometimes just minor little adjustments, little tweaks, little support here, little shift there makes all the difference in the world, and if you don't know, you don't know right, and so reach out and get that support that you need. Okay, so a deep latch.

Speaker 2:

What we look for on a deep latch is when the baby is on the breast and sucking right. We have to kind of have sucking going on to be able to see this. But we will see a pulsating movement, kind of right in front of the baby's ear, where their temple is. So as baby's sucking mom, you can feel the baby sucking usually, and then others. We can feel the baby sucking usually and then others we can see the baby sucking. So there'll be kind of a pump, pump, pump, pump, whatever the cadence of the sucking is right. So you'll kind of see a pulsating in front of the baby's ear. If we are getting some movement and there's really a lot of fast movement but there's not pulsating by the baby's ear, that baby might not be on very deep. We might kind of have a shallow latch.

Speaker 2:

Another thing we look for is jaw movement. So that whole jaw should kind of be moving. We want the baby's jaw which travels up into their ear that's why we're seeing it on the ear, in front of their ear, on their temple that whole jaw should kind of be involved in a long pulling, suck motion. What we don't want to see is what we call dimpling. So if a lot of the movement is right by the baby's lips, so right where a dimple often is right, and this doesn't. If your baby has a dimple doesn't mean they're going to be doing dimpling by any means. But if we see dimpling, that means the baby has a pretty shallow suck, almost like kissy lips right, and so if they have kissy or fish lips that aren't big and wide, then they're going to have some dimpling and we'll see the more of the movement in the cheek, not in the jaw and by the ear. So that's one thing to look for.

Speaker 2:

Another thing to look for is the gape or the opening of the baby's mouth. So we want that baby's mouth to be very wide open. So we all know what a 90 degree angle looks like. Right, it's like a square. So there's a 90 degree angle. We want the baby's gape to be like 140 degrees, really wide. So I like to take my hand to show people. So, if you like, stretch your thumb and your hands as wide as you can. That's like 140 degrees. Baby's mouth should be very wide open.

Speaker 2:

If we're seeing a very small angle 90 degrees or less, what I call a triangle, right, so the corner of that baby's mouth is making a little tiny triangle that you can see. Then that baby is pretty shallow and sometimes we can't see that angle very well. Why? Because there's a breast in the way. So some people have very soft, supple, large breasts. They're going to just envelop the baby's head. So kind of pull back the breast so that you can see. I like to let a baby do several sucks before I check this and I'll just gently pull the breast back.

Speaker 2:

The mom can do this. A partner can help with this If mom's hands are busy, because a lot of times mom has a hand on the baby's head, hand on the breast. She does not have three or four hands. She needs them, but other hands can be pretty helpful. So maybe someone else kind of pulls back that breast tissue gently. Let the baby get a good rhythm first, and do it gently so that we're not disturbing the latch. Just kind of pull the breast tissue back to see the gape or the opening of the baby's mouth.

Speaker 2:

On other people, depending on their breast anatomy, you can just glance down and absolutely see that their mouth is wide open. There's no little triangle in the corner of their lips where the upper and lower lip meet. We also want to look for flanged lips, right. So flange just means pointed out. So we've got the upper lip, that's kind of folded up and out. Bottom lip too, if we have them curled under not ideal. So just you can kind of flip it up with a finger, with a thumb, to keep that lip up. So those are some things to look for.

Speaker 2:

And then those of you who are breastfeeding, there's things to feel for right. So there's the visual components and then you'll learn to feel what a deep latch feels like. It should not hurt. So many people say breastfeeding is painful. It's tough for me, like gosh way. Tougher for the moms, but hard. When I see a mom as she latches, she winces in pain, you know. She kind of scrunches up, her shoulders are tight, like she's not having a great time, like something's up with this latch. It should not feel like that. It shouldn't hurt that acutely. So keeping a nice deep latch is going to be helpful and you'll. If you feel pain, sharp pain that lasts the whole feed, if you're feeling if the nipple's getting damaged, that's a sign of a shallow latch. If it hurts the entire time, that's a sign of a shallow latch. So we want to deepen that latch.

Speaker 2:

Now, one thing that I love to work with is deepening a latch, not relatching all the time. So if we don't have a latch, that's great. You can work on deepening the latch without unlatching the baby. Some babies get pretty frustrated being latched on and off all the time, trying to get a deep latch. Some nipples don't like it either. They're like oh, again, again, again, no, so we can kind of just work with what we have.

Speaker 2:

So when you get that baby latched, one of the easiest things to do and it's pretty simple, right, it's simple. This is not rocket science it's just to keep that baby close, close to the mom, remarkably close. So a lot of times the mom will have one hand on the head. So this might, might we call this cross cradle. I wish I could draw a picture for you or show you in person, but if I have the baby on the right breast, my left hand for the mom is the forearm, is supporting the baby's body and my left hand is ear to ear. So I got basically right behind the baby's ears. That gives me control of the baby's head. My other hand, my right hand, is on the right breast, supporting that, and we bring those two things together. So we kind of want to I call it womp the baby on there and keep the baby remarkably close. Gravity works, it's a real thing.

Speaker 2:

So as we're hanging out there for the duration of a feed whether that's 10, 20, 30 minutes moms, sometimes our attention drifts or our hand gets tired and we don't hold that baby crazy close and that baby can drift off. They kind of fall off the nipple. We get triangulation, I call it. We're seeing that triangle in the corner of their mouth. They're falling shallow on the nipple. They're just sucking the nipple. They might suck away happily, but they're not deep on the ducts behind the nipple and they're not getting milk. There's not a great transfer rate usually and it can cause pain for the mom during that feed.

Speaker 2:

So one of the tricks to keeping a deep latch is to keep the baby remarkably close. Now something I will do almost every time in hospital, in home, is give that mom some support as far as something to bolster her hold. You know, because a lot of times we are sitting straight up or just a slightly bit reclined and we're holding that baby in front of us. I like to put I'll roll up a little baby receiving blanket or a hand towel, what you can use. A corner of any blanket really. If it's an adult size blanket, just roll that up and put it under the mom's wrist. So if she's holding the baby's head with her left hand baby's nursing on the right side, the right hand is controlling the right breast put a tuck I call it a tuck under the mom's wrist. That will help hold the baby remarkably close so the mom can relax her hand. Yes, she's holding the baby, but that tuck is doing the the work of holding the baby close. So that's a little trick you can work on to keep the baby close and just kind of watch. Watch for that deep latch.

Speaker 2:

Um, and babies, over time, as they feed they get a little tired. As their belly fills up they get a little sleepy, kind of slow. They're sucking, and then that might help them or cause them to have a more of a shallow latch. So stimulate them a little bit. Just wiggle them here and there, tickle their feet.

Speaker 2:

You have two hands on, two things, usually for a while in the early days One hand on the baby's head, one on the breast. Wiggle something. Wiggle the breast, wiggle the baby's head. You can do breast compressions. So you're kind of like not right at the nipple because we don't want to disturb the latch, but further back, just like pump the breast, and that those are called breast compressions that can help push a little more fluid into the baby. If we're having questions of a lower milk supply, that's increased breast stimulation to help milk supply, especially those ducks that are a little bit farther back. So there's a few things you can do to know that you have a deep latch, to be able to get and keep a deep latch, because when the latch is deep our nipples won't be sore, babies will gain weight, babies will be satiated. They're not going to be so fussy. Hopefully they can sleep, get to sleeping a little longer.

Speaker 2:

But almost every problem that comes up with breastfeeding we're going to go back to latch. Like, what's going on with the latch Now? There are layers of challenges we will look at. We'll check the latch, check the positioning, see if there's some little tweaks or adjustments we can make, and if that doesn't work, we go to the next level. Right, we're going to take a peek in that baby's mouth.

Speaker 2:

A little bit deeper exploration of what's going on with the anatomy of the baby and how is that matched up with the anatomy of the mom. You know, like when we look at like oral restrictions, which are tongue ties, cheek ties or buccal ties, lip ties, and maybe this baby can't get a great latch, we'll also look at the mom's anatomy. Maybe the nipple is very short or it's flat or inverted. By the way, inverted nipples, truly inverted, are quite rare and flat nipples can be pulled out. So we'd look at using something like a nipple shield. So what can we do to work with the mom's anatomy to match it up to the baby's anatomy? So, but first and primarily, we're going to look at the latch.

Speaker 2:

So, going into this, remember to keep a deep latch. You can work and get a deep latch by two things I like to do to get a make a latch deeper rather than take the baby on and off. One is kind of I call threading a needle, so you're threading more breast tissue into the baby's mouth. So again, let's say we're holding the baby so that they're breastfeeding on the right side. The mom's left hand is at the baby's ears, so her forearm is supporting the baby's body, holding the baby close to her. The right hand is on the breast. So if our latch isn't amazing and we can tell that by looking at the baby and what it feels. Like mom, you can take your thumb on that breast, hold the baby remarkably close with your left hand and then your right hand, take that thumb and kind of push more. It's like you're pushing breast tissue under their upper lip so you can get that latch to become deeper. And with your left hand you're keeping the baby very close, snugged up close.

Speaker 2:

Another way to do it to deepen a latch while the baby's on. It's called like a chin pull. Somebody else usually has to do this because the angle and the. You need four hands for this one. So we've got a mom holding the baby, holding the baby's head and the breast, holding them together. Somebody can come from above the mom and sneak your little hand, your finger, your index finger, whoever's helping I do this many, many times a day sneak that finger onto the baby's chin. So you're going between the breast and the chin while the baby's latched and sucking and just kind of put the finger on the bottom of the baby's chin and roll down the chin. It's kind of a fluid motion to roll down and at the same time you're rolling down the chin you're kind of broadening their mouth gape and then gently push the top of their head, the crown of their head, forward, so that will help them get a deeper latch while they're on without take them on again, off again, because nipples sometimes can't handle that very well and neither do babies like it if they're getting disturbed all that often.

Speaker 2:

So that's some ways we're going to conclude this episode about latch what a deep latch looks like, feels like and how you can achieve it. Sometimes it's not possible, but we want to try and then we work from there. We don't jump to the biggest problems, kind of start low and work up as we need them. Thank you so much for being with me here today. Hopefully some of this has been helpful and you are able to feed your baby in a way that feels successful, sustainable to you and get the support that you need. There's a lot of lactation help to be had in the world out there. Ask around and see what's available to you. Thanks for being with me on this episode. Hopefully you can get a deep latch, keep a deep latch, so that we have positive breastfeeding experiences. Hope you have a great day. My name again is Angie Rozier. This is the Ordinary Dulo podcast. Signing off and please make a connection with someone you love today. Make a difference in their life. You never know what that will bring Hope to see you again next time.

Speaker 1:

Thank you for listening to the Ordinary Doula podcast with Angie Rozier, hosted by Birth Learning. Episode credits will be in the show notes Tune in next time as we continue to explore the many aspects of giving birth.