But They Said the Latch Looked Good (updated)

Edited repost of the 2015 blog post of the same name.
author: Jeanette Mesite Frem, MHS, IBCLC, RLC

How many times have you heard someone say "well, at the hospital they said his latch looked good" but yet the parent (or baby) is still having breastfeeding issues like pain, long feeding sessions, lack of effective milk transfer, excessive crying between feeding sessions or moving off the breast and back on frequently during one feeding?

I hear this quote all the all the time.

"But in the hospital they said his latch looked good!"

I hear it in my feeding support group. In private feeding consultations. Online. It's an epidemic.

Did you know that hospitals are pressured to have high breastfeeding rates...what that actually means is that if a baby latches onto the breast at least one time before discharge, they can check the box for "breastfeeding". Yup. Once. Check the box, people, the baby latched! Many hospitals in our area (Massachusetts) have about 80% "breastfeeding at discharge" rates but a high percentage of babies are discharged having had formula during their stay, too, because getting the baby to latch effectively isn't always happening.  And one time does not a success make.

Who are the helpers?  Nurses, lactation consultants, doctors and midwives. They all care, but not everyone you encounter at a hospital knows your whole story nor are they allowed the time to really sit with you, listen and see what's going on with nursing and milk-making. It's not a perfect system. Any nurse or hospital-based lactation consultant will tell you that. Nurses don't get the training they need to be able to provide as in-depth care as may be needed and lactation consultants have to see too many mom-baby pairs each shift. They can only comment on what they see when they are in your room. AND there are pressures from the administration as well to see many babies and some hospitals have "gag orders" against talking about possible tongue ties. One lactation consultant at a Boston-area hospital told me (in person, to me and about 100 others in a room at a perinatal health conference) that she would be fired if she ever uttered the words "tongue tie" at her hospital again. Yep, fired. 

[insert pause here to allow time for your loud gasp.]

via GIPHY

What is a latch, anyway? There are long discussions in the lactation world about how to assess a latch. There is even an assessment tool that assigns phrases to each letter of the word LATCH. Here's my interpretation of that acronym.

L: can the infant latch to the breast or chest (or even the bottle!) deeply and sustain the attachment and suckle?

A: can we hear audible swallows?

T: what type of nipple does the parent have (everted, inverted, flat, long, large)?

C: is the nursing parent comfortable?

H: how much help does the parent need to keep their baby in a comfortable position at the breast?

Each aspect is important but ultimately, if the latch looks beautiful (lips flanged out with mouth wide) but the parent is not comfortable and/or getting soreness, cracks and even bleeding OR baby isn't transferring the milk that we know the parent has, then there's something not quite right. Period.

If it's not comfortable, ask for help. If you get help and are still experiencing soreness, get more help. If you need to stop nursing for a day or two or three to pump and heal your nipples, fine. Feed the baby. Heal the nipples. Protect the milk supply. And get help.

Too many families start out saying that breastfeeding is important to them but then ultimately I see or hear that they have quit in the first two weeks of their baby's life because their nipples are in too much pain or their baby isn't gaining weight. Hey, if a person doesn't want to breastfeed, that's their business. But if they do and they don't know how to get help? That pisses me off. Yup. Mad. I didn't get into this profession because it's particularly lucrative. I'm passionate about helping parents meet their feeding goals and helping babies drink effectively. 

Were you helped in your baby's first two weeks of life? Did you know where to turn? Did breastfeeding go well for you at first? Is it easy, not for everyone, but neither is learning a new skill...but we ask for help, get training, get second opinions, ask friends, ask those who have done it successfully and sometimes have to hire a coach. And be dedicated. It's a team effort, really, would you agree?

If you need help with your baby's latch, 

Schedule a Feeding Consultation