__ In the cradle or cross-cradle positions, the baby should be resting on his side, his tummy facing your tummy, shoulder and hips aligned, mouth level with the nipple

__ The baby’s mouth should be covering at least a half inch of the areola, the dark area of skin around the nipple

__ His nose is touching or nearly touching the breast

__ Both the top lip and bottom lip are flared out

__ Once your milk lets down (starts to flow freely), you can see the baby’s jaw moving all the way back by his ear

__ The baby’s temple may wiggle, too

__ You can hear the baby swallowing (you might notice a pattern, such as “suck, suck, pause for swallow.” The pattern will slow as the baby fills up and takes in less milk). Dr. Jack Newman describes an “open mouth wide – pause – close mouth” pattern that indicates whether the baby is swallowing big mouthfuls of milk.

__ Absence of pain (if breastfeeding doesn’t hurt, that’s a great sign that the latch is good. Some women may experience initial soreness, tenderness, and even pain in spite of a good latch, but it’s a good idea to work with a La Leche League leader and/or lactation consultant to rule out problems with latch, thrush, or other things that could cause pain).

__ The baby’s tongue is extended over his bottom gums and is cupping the breast (if you peeked, you could see a little triangle of tongue in the corner of his mouth, but there’s no reason to peek if everything feels right).

__ When the baby pops off (or the latch is gently broken), the nipple does not look unusually squished or angled like the tip of a new lipstick (a distinct line across the nipple might be a sign of tongue-tie).

One final way to gauge latch (and the baby’s consequent intake of milk) is to watch the baby’s output! Is the baby having enough wet and poopy diapers?

Post from: Breastfeeding 1-2-3

“Some tenderness…” Right…. I can’t tell you how much Lanolin I used each time (I’m nursing my second now) and it STILL hurt like hell in the beginning. I am quite sensitive to pain. What would have been helpful with my first was knowing that a) we were doing it the right way and b) the pain would eventually go away. As it was, I concluded that if she was getting milk and thriving, we must be doing it right.

While I wouldn’t suggest toughening your nipples (why start the pain early?), I can certainly see where the practice came from. I’ve seen this advice in many different bf’ing resources, I really feel that this is not helpful to women just starting out with bf’ing. Sure, you have to get the latch right. But if it is right, and it still hurts, knowing that eventually the pain will go away would be more helpful. Otherwise, they may give up, thinking that “it just doesn’t work for them.”

Just my 2 cents…

Dawn

Dawn, thanks for sharing your thoughts. You’ve got a good point. I know at least two mothers for whom breastfeeding hurt for a number of weeks and then the pain simply went away. There are a few reasons why a mother-baby pair might “outgrow” nursing pain.

It’s possible in such cases that the baby has a short frenulum (”tongue-tie”). While it might be necessary to consider clipping a short frenulum, it is possible for the condition to improve on its own. The Breastfeeding Answer Book states:

Breastfeeding problems related to a short frenulum may resolve over time without special treatment. The movements of the tongue may cause a short frenulum to stretch (Riordan and Auerbach, p. 357) or the baby may adapt his mouth and tongue movements to improve breastfeeding effectiveness.

It’s also possible that the baby simply has a short tongue. In that case, improving latch-on and positioning helps in the short-term, and in the long term breastfeeding gets easier and easier as the baby’s tongue grows.

For some nursing dyads, there may be an unusually great disparity between the large size of the mother’s areola and nipple and the small size of the baby’s mouth. In most cases, as tiny as the little newborn seems, the baby can get enough of the areola for a proper latch, but in some cases it can be more difficult at first and the problem gradually lessens as the baby grows.

I hate to hear of mothers simply bearing the pain (although kudos to those who work though that difficulty!) as perhaps there are some techniques that could help. As I mentioned above, a baby with tongue-tie might require a frenotomy (also called a frenulectomy or frenectomy). If the mother cannot find a doctor willing to perform the surgery or if the mother does not desire surgical intervention, there are some exercises to try to help the baby learn to extend his tongue. Short-term use of a nipple shield might help alleviate the difficulties as well.

The other problem I have with telling women to just hang in there — that there will be pain but it will go away — is that there are other causes of nipple pain that will not correct themselves with time (thrush being an example that springs to mind). Seek help if you’re in pain. At best there will be a solution, at a minimum there will be support to get you through hard times such as Dawn’s.

Post from: Breastfeeding 1-2-3