Help for Latch-on Problems
|Marie Davis RN IBCLC||
Babies can Self-Attach to the Breast
The now classic work of Adelaide and Righard in 1990 and the video from Geddes Productions, “Delivery Self Attachment,” taught us that a newborn baby will crawl up the mother’s stomach and chest, and self-attach to the breast. At first, we thought there was a very specific window of time where baby was capable of self-attachment before the ability disappeared.
Lactation consultants, like myself, began wondering if this group of reflexes persisted beyond the newborn period. In my lactation practice, I often noticed moms whose arms and hands were so tight and tense that their babies were having difficulty latching-on. The babies did much better if I had moms use a “hands off” method, allowing baby to take the lead.. (I would have them place their hands at their sides or along the back of the sofa, while I put the baby on her chest and the baby would almost always latch on, without any help from mom or me.)
As it turns out, self-attachment reflexes persist for several weeks or months after birth. What we once called the “stepping reflex” in newborns, may actually be one of a set of reflexes geared to help the baby “crawl” (more like scooting movements) in order to find mother’s breast.
All babies are indeed, hardwired to breastfeed. The "Mother Baby Dance" and "Laid Back Breastfeeding" are techniques that make good use of self-attachment reflexes.
“Hands off” techniques for latch on
It seems like common sense but, it never does any good to stress the baby at the breast. I advise mothers whose babies will not latch to try a “hands off” approach -- just lay back and let Mother Nature take over. Personally, I have seen mothers attempting to latch a baby on for up to 60 minutes at a time (8 or more times a day). It is frustrating and exhausting for both mother and baby. These babies can become frantic, almost phobic, at the breast, thrashing and crying, while obstinately refusing to latch on. This takes an enormous physical and emotional toll. For mom, her baby is objecting to her. For baby, all he "knows" is he's hungry. A crying baby and tense mother are almost always counterproductive to successful latch on.
The baby that has never latched on and the mom who exclusively pumps.
I think lactation professionals would be truly amazed by how many women exclusively pump for their babies. For whatever reason, they just never got the baby to the breast in the first few weeks. Perhaps, their babies were bottle-fed as preemies in the nursery and when they got home breastfeeding was foreign for both of them. Mom gets worried that baby isn't eating, so she continues to pump and bottle feed her milk. Many these women exclusively pump for weeks or months. It's not like mom hasn't "tried" to get the baby to the breast. In fact, they've struggled, tussled and really fought to get the baby latched on. For some, small victories are rare, for others, it becomes one step forward and two steps back. .I have seen far too many women held captive by that pump for a year or more. Many of them believing that their opportunity to breastfeed has passed them by. No one ever told them that the baby could still "learn" to breastfeed. No one even dared to tell them that maybe, just maybe, baby could still learn to nurse without any help from them.
There's no magic age where it is too late begin breastfeeding. The baby still knows what to do; something has interfered with the natural processes. Skin-to-skin contact will stimulate the baby's natural instincts for latch on. As long as baby is calm, it may take a half hour or more for baby to find his way.
It is important that there is never any pressure on the baby to latch-on. Mom should try, but never insist, that the baby latch on. If the baby becomes distressed and does not latch-on, feed the baby by another method, and try again in a little while.
Heather Harris, a midwife from Melbourne, Australia, has used a technique called, rebirthing (465-468), quite successfully for babies with severe latch-on problems. The procedure is a totally non-invasive way to help mother and baby relax with one another and "reconnect" as they should have immediately following birth.
I have found this technique useful. Sometimes, like following a Cesarean Section, a difficult labor and delivery and/or a prolonged separation of mother and baby, I see women in a kind of “mourning” over the “loss” of the birthing experience. I have received numerous letters from women who found the rebirthing technique helped heal those emotional wounds.
Helping Hands on for Latch On
So why do lactation consultants take so much time teaching women how to latch the baby on? First, in western society, most women have never seen a baby latch on to the breast. So talking about it and showing women how to latch on, maybe the only exposure new moms have to breastfeeding in a bottle feeding culture. Second, some babies need a gentle nudge or extra help to latch on.
A lactation consultant who has watched hundreds of infants can see and feel the subtle signals a baby makes before latching on and can help that baby get latched on. The lactation consultant can guide the baby to the breast more quickly than mom. In the past some LC's actually grabbed the breast and the baby to latch baby on. It gained the nick-name the "RAM technique" (supposedly for "rapid arm movement"). I confess that was the way I learned and worked, for several of my early years. Problem was that if mom didn't do it by herself, she went home to a frustrating routine of trying to latch the baby on "the way the lactation consultant did." Mom's problems would only increase and unfortunately, a number of them were often too embarrassed to come back.
Most lactation consultants today prefer to step back and watch what the infant is doing and guide mom.
One woman said that if she had to give one piece of advice to any mother going through a rough time it would be:
When the technique works the smile on the mother's face is priceless.
Harris' rebirthing process
It is very important that the mother and baby not be left alone during this process. The baby or mother could drown. Mothers should be warned not to try this by themselves. There MUST be an extra person present who is in charge of the infant's safety.
One more thing . . .
Breastfeeding is simple, right? Not so much when things aren't working the way they should. The first rule of breastfeeding is to feed the baby. I find women playing "the blame game" because baby will not latch-on to the breast and they had to use bottles. What else is she supposed to do? There is no blame here. Mom does what she has to do for her baby.
Severe latch-on problems are usually the result of the domino effect: one thing leads to another and the whole thing falls apart. But for most, whatever it was or is --- it's not a reason to quit trying --- it's a reason to quit "trying" so hard.
What is important is to remember that babies are pre-programmed to breastfeed and in the vast majority of cases, mom is not doomed to pump and bottle feed her milk. There are several internet message boards dedicated to pumping moms. I have the privilege of being the member one group for several years. Their dedication and determination literally floor me. The support they give each other is immense. These women have chosen the only alternative they see for feeding their infants and deserve not only respect, but admiration.
It is my hope that many of these moms are able to use the techniques above to get their babies to the breast.
(References go to Works Cited)
Harris, Heather. "Remedial Co-Bathing for Breastfeeding Difficulties." Breastfeeding Review 11:10 (Nov 1994) 465-468.
Last Reviewed: Saturday, February 11, 2012 11:14 AM