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Episode 54: Why the Latch Matters (and How to Get a Great One)

, August 19, 2021

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Welcome back to another episode of Breastfeeding Talk: Milk, Motherhood, Mindset. I’m your host, Jacqueline Kincer. And in today’s episode, I really want to talk about something that I’m super passionate about. And that really, really needs to be talked about. And that is the latch. The latch at the breast we’ll talk a little bit about the latch the bottle as well. But it’s so so important. And I think that it’s it’s something that is honestly completely misunderstood. It is completely undervalued when it comes to breastfeeding and breastfeeding success. And it’s really one of the core pieces, the foundational pieces that is going to make or break breastfeeding for most moms and babies. So let’s talk about this. Not any latch is a good lash. Okay. So if you if you’re breastfeeding, and the latch looks shallow, but you don’t have pain and your baby’s gaining weight, great. That’s still not what we want. That is still not a good latch. And we need to work on it. Why do we need to work on it?

Well, there’s a lot of factors. But I am going to try and explain this in a way that I can do it where there’s no visuals, because we’re here on audio. So the baby’s lips, let’s talk about that. Because this is one of the most obvious things that we can see when it comes to the latch. And by the way, I do want to stress this, that no matter how the mouth looks on the outside, it’s actually even more important what’s going on in side the baby’s mouth. So can a baby have what I would say is a good looking latch but still not be feeding? Well, because they’re not moving their tongue properly in the mouth, absolutely. See it very often. So that’s kind of a separate issue. But but as far as the logic goes, let’s talk about the appearance of the latch. So there’s this misconception out there that the upper lip needs to be flashed out. This is not true. If your baby has an upper lip that is flashed out, they have a shallow latch. Now, some of this might be just, you know, a thing that we’re dealing with in terms of vocabulary and words. But I think that it’s really important to be intentional with our words, so that there is no misunderstanding. If a lip is flashed out, like let’s say the upper lip, for instance, that means that lip is rolled back.

And it’s actually touching the philtrum, which is the skin that space between the bottom of the nose and the actual pink part of the lip. Okay, back to the philtrum. We don’t want the lip flange out, we don’t want it curled back, where we’re seeing the pink of the lip fully exposed. And that lip is being flashed out to look like you know we’re making some sort of a fish face. We do however want that to be the case with the lower lip, the lower lip should be completely flashed out, rolled back so that it’s actually touching the top of the chin. So that is important. Okay, we just don’t want the upper lip curled under, we don’t want it rolled under pay. So really, if you’re going to see any pink of the lip at all, it’s just going to be the edge of the vermilion border where the skin turns from flesh tone to a more pink or brown lip tone. So just to be clear, the upper lip should be relaxed, it should be neutral, it should not be curled out and it should not be curled under. So it’s kind of like Goldilocks, right somewhere in between.

When the lip is, well when the baby’s latched at the breast, there shouldn’t be any tension around the lips, there shouldn’t be any blanching where the tissue is turning white as it’s moving or latching on to the breast. It also shouldn’t be forming any sort of creases that are creating sort of red lines around the mouth or the face. And it shouldn’t be creating any sort of pink from tension or stress on the tissue. So just to be really, really clear, that’s what’s ideal. Again, the lower lip should be flashed out. But let’s also talk about another part of the lip which is the corner of the mouth. The corners of The mouth should not look like corners of the mouth when the baby is Lashed to the breast, they should be rounded, there should be no crease, no pinching, the corner of the mouth should actually be flush against the breast, there should be no gap between the corner of the mouth and the breast.

So I don’t want it to look like a Pac Man, or you know, a greater than or less than symbol, I want it to look like a nice crescent shape that is gently hugging the breast. So if we want to talk about angle and mouth opening geometry of the latch, so to speak, the baby’s mouth should be open at around 140 degree angle. So I don’t need you to get out your protractors. But we all know what 180 degrees looks like, right, it’s going to be a little less than that. But it’s definitely going to be a lot more than 90 degrees. So keep that in mind. 140 degrees is basically the angle that we’re going for. Okay, so I know a lot of you are who are listening. If you’re breastfeeding and you’re struggling with the latch, you’re probably thinking there’s no way I can get my baby to open that wide, it probably has to do with your latch technique, which I’ll talk about. So the other part of the latch that’s really important. Just slow this down for a minute, you know, in the in the when the baby is in the process of lashing. Really, the first thing that needs to happen is that their lower lip and their chin comes to the breast touches the areola, right, and then their tongue is actually going to extend forward, they may actually lick the breasts, they may stick their tongue in and out, it’s going to cover the lower gums and it should also cover the lower lip. The tongue is responsible for what we call the oral grasp.

Meaning that that tongue is going to extend beyond the lower gums. Especially once a baby has teeth, it’s going to protect those teeth from touching the breast right or the firmness of the bone of the gums from chomping on the breast and creating pain and compression. And then it’s going to also extend over that lower lip. Remember the lower lip flanges out it’s really not even touching the breasts that much it’s just kind of the edge of the lip is is touching the breast and creating a seal. But it’s not actually grabbing onto the breasts, the tongue that’s over those lower gums in that lower lip that is actually grabbing onto the breast. So the tongue extends outward, the sides of the tongue curl up to create a seal and to grab onto the breast and to also hold on to it and pull it in to the baby’s mouth. Now once the breast is in the baby’s mouth, there’s a wave like peristaltic motion that starts at the tip of the tongue and goes towards the mid and posterior tongue. And so the baby is grasping onto the breast It begins at the tip of the tongue, there’s a little bit of elevation there, and then that elevation moves back from the tip of the tongue to the back of the tongue. And that is what creates pressure in the baby’s mouth. That extracts the milk from the breast. So breastfeeding is not suction.

That’s not what’s happening. In fact, the technical term for what the baby does is the breast is suckling. It is not sucking, it is suckling with an L. And this is something that we know when we’ve known for a very long time because of ultrasound studies that have been done on breastfeeding babies, bottle feeding babies, baby sucking on pacifiers, all sorts of things, right? So we know what’s happening in the mouth, we’ve actually been able to measure what’s happening in the mouth, the baby’s tongue, mostly the mid tongue, which a lot of people might call the posterior tongue, but that’s actually just technically inaccurate, but it’s the mid tongue or you can think of it as the back of the tongue. If you’re just a lay person, right? You’re not a medical professional listening to this. And that part is what really elevates up to the roof of the mouth and down again, and it elevates up to the soft palate. So that mid tongue rises and should meet with a soft palate that drops and those two come together and form a seal in the back of the mouth.

Okay, so when that happens, there’s a vacuum that’s created in the mouth. When the baby’s tongue drops again, there’s a change in pressure, it creates negative pressure in the baby’s mouth, and the breast that’s full of milk has positive pressure. Now, if you know anything about physics, or or just pressure in general, right pressure wants to equalize. So there’s positive pressure in Nebraska negative pressure in the baby’s mouth that wants to equalize. That’s what actually makes the milk go into the baby’s mouth is that pressure differential? So the baby’s tongue drops that negative pressure is created. The milk comes in the baby’s mouth, and as that tongue drops, it allows the milk to come into the mouth. Again, the posterior tongue is elevated. The rest of the tongue is not it is down at the floor of the mouth. And then the baby’s tongue moves up at the tip of the tongue and pushes that milk down in a wave like motion down their throat first night Clean swallow. Now if the baby has poor oral function, or has a tongue tie or some limiting factor, like not a good latch, or some sort of structural anatomical issue that is preventing that mid tongue from rising and fully meeting with that soft palate, that’s when they end up swallowing air during the feeding. This is how we get arrow fija induced reflux.

So most reflux, and yes, I would actually say that probably most of it that isn’t, you know, readily, you know, figured out by virtue of the baby’s house formula, or a food intolerance or what have you, is probably caused from the baby actually swallowing air at the breast. They don’t swallow air typically, because it’s coming in where the lips meet the breast, although that can certainly happen. But most of the time it’s happening in the back of the mouth, because the back of the tongue isn’t elevating up to that soft palate closing and creating that seal. So when the baby’s drying the milk in there also drawing air in because they’re breathing through their nose, and that air and milk gets mixed together and swallow together. Now sometimes that air bubble comes out in burping, sometimes it comes out with milk, and then we call that reflux. Sometimes it stays in their digestive tract, because that era bubble is in and then a bunch of milk went on top of it. So now it’s really hard to get out and your baby’s colicky and uncomfortable, their stomachs distended, right, and then sometimes it comes out as gas. So that’s a bit more of the mechanics of what’s going on in the baby’s mouth. Now, the tongue needs to cross that distance from the floor of the mouth, to the roof of the mouth. And the whole tongue needs to do this, not just the tip of the tongue. So this is why tongue ties are problematic.

But we also need the baby’s mouth to be open wide, so that the breast tissue, not just the nipple, right, it’s breastfeeding, it’s not nipple feeding. So try to remember that it’s not so much about the nipple, I very rarely think about the nipple. In terms of breastfeeding, I think about the breast, right, we want a nice chunk of breast tissue to come into the baby’s mouth. So much so that the place towards the nipple really the areola, right behind the nipple, we’re all of those milk ducts converge together, that that sort of pooling of milk right there, that that part of the breast is actually in the baby’s mouth, so that it’s not being pinched off. Right, if the baby has a shallow latch and is just latched on to the nipple, or right behind the nipple, they’re actually pinching off that part of the breast where all the milk ducts converge. And we have a pooling of milk that’s ready and raring to go. Right, it’s ready to exit the nipple go in the baby’s mouth. But now some of it comes out of the baby’s mouth, but a lot of it is pinched off. And try to remember this, you know, your milk ducts on your breast are much like the veins on the back of your hand. So just a small amount of pressure can actually cut off the flow. Now if you put a push on a vein on the back of your hand, and you don’t push on it too hard, some blood flow is still circulating, it’s still going to get to your fingertips, right, it’s still gonna go to all of the tissues past that point to the end of your hand. But it’s not going to be as good of a flow, right, some of that bloods going to back up or whatnot or be redirected into another area.

This is how we end up getting things like clogged ducts or mastitis, because we’re preventing that nice flow of knock. So the babies latch, even if they can still get milk, even if it’s not causing you pain. If there’s a slow of efficiency, if there’s a problem in the transfer of milk, if insufficient pressure is generated in the baby’s mouth, maybe it’s not causing immediate problems, but I promise you, it’s going to cause problems down the road. And it’s either going to lead to a decrease milk production, usually around the 12 week postpartum Mark, when your hormones are no longer responsible for milk production, right? So we switched from an endocrine driven lactation process to an autocrine driven lactation process, meaning instead of your endocrine system, your hormones, the birth of the placenta, the fall of the progesterone, the rise of the prolactin all of that is what’s responsible for the beginning stages of lactation. Now, lactation switches away from being hormone dependent to being dependent on how well the milk is removed from the breast and how frequently it’s removed. If there is an insufficient or in efficient removal of milk from the breast, then your body thinks that it doesn’t need to make more milk because there just isn’t a demand for it. So when I hear stories of moms that say, Oh, well, my milk just dried up at three months just out of nowhere. No, it didn’t. There was definitely a problem. But that problem got missed probably because the baby was initially gaining weight great. And there was no pain for the mother or maybe there was pain in the first two weeks and then it went away. So mothers are often dismissed.

With these initial concerns. They’re told these things are normal. They’re told that the gold standard of Whether or not breastfeeding is going well is how well the baby is gaining weight. And that’s just not true. The mechanics of breastfeeding matter. And they matter the most, quite honestly, not only that, in terms of how much milk the baby’s getting are preventing, you know, breast problems for the mother. But if the baby has a poor latch, they’re actually using the wrong muscles, they’re having to work harder to feed. So sometimes these babies are babies that tiger very easily at the breast, they fall asleep before they finish a full feeding, or they feed more frequently, or they experience a witching hour because they’ve been overworking their jaw. And they’re temporomandibular joint, that muscle right there, the masseter muscles, one of the strongest muscles in the body, and it’s exhausted at the end of the day and is like I don’t want to do this anymore. Right, some of these babies end up refusing the breast or have a bottle preference because sucking at the bottle is much easier, doesn’t require as much Tang motion doesn’t require them to open as wide. So there’s a lot of cascading problems that could have all been headed off at the pass come you just got the right latch technique from the beginning. And unfortunately, very, very unfortunately, I would say most of the time, mothers are not taught how to latch properly either in a breastfeeding class that they took while they were pregnant, in the hospital, even if they saw lactation consultants, and sometimes even in private practice, but it’s more rare. Usually those of us ibclcs in private practice know exactly how to help you get a good lunch. And then we have to teach you to unlearn everything they taught you in hospital because it’s wrong. So it’s not nipple to nose, folks, let me just tell you that okay, nipple to nose. If you’ve been told that phrase, I want you to delete that from your memory.

And I want you to go empty that recycling bin on your brain computer, and just get rid of that entirely. Also, while we’re at it, let’s delete for milk and milk imbalance. That’s not a thing. So let’s go ahead and delete that one too. That’s a whole other podcast episode. But it’s not nipple to nose, it is nose above nipple. So remember, I told you about a body part called the philtrum. That’s between the pink or brown of the lips, and the nose, the nostrils. It’s that fleshy part right there. That’s the philtrum. Okay, it’s it’s not with an F itself, Phil, tr, un so philtrum. Okay, your nipple, when you’re going to let your baby is at the philtrum it is under the nose. If your nipples at your baby’s nose, it’s just too far they can’t reach it. So frustrating. It’s frustrating for you, it’s frustrating for them. And then what ends up happening is that now you’re guiding and directing your nipple into your baby’s mouth. Now, I would venture to say that probably 95 to 98% of moms start out latching their babies by putting their nipple in their baby’s mouth. And unfortunately, that is going to make breastfeeding harder. You are kind of running uphill when you when you do that. And the reason for that is that breastfeeding has a lot to do with your baby’s posture and reflexes. There is an occupational therapist out there. So I’ll give her credit for this. Her name is Miss Michelle Amanuel. She teaches the tummy time method. And she has a saying that breastfeeding is a postural event. And I have to 100% agree with her. Because positioning it matters. And it matters for the reflexes. The reason why tummy time is important has to do with your baby’s newborn reflexes. So think about the rooting reflex, the Moro, reflex asymetric, tonic neck reflex, the Babinski reflex where you tickle the foot, right? There’s all sorts of these primitive reflexes that babies are born with. And they come along and integrate at different stages. And it’s really important for their brain development. And really so much of their entire development. There’s adults out there who really don’t have properly initiated or integrated primitive reflexes, and it does cause problems later in life. So breastfeeding is one of those ways that when I say that breastfeeding is a complete system, I truly truly mean that because breastfeeding is you know, 20%, milk and 80% everything else, because it’s their posture, it’s their jaw and facial and airway development and growth. It’s their brain development, it’s their emotional regulation. It’s their intuitive, attunement, right. It can even be a spiritual experience between the mother and baby. There’s so many things that breastfeeding offers. Now, that’s not to say that if you are bottle feeding breast milk that you know it’s the end of the world and you’re a bad mom and it that’s not what we’re saying.

But breastfeeding is a very intelligent system that was honestly divinely designed because of all that it does for a baby. So when we talk about these primitive reflexes that babies have leveraging those reflexes, is what we’re supposed to to do when we feed our babies, but we’ve lost this inherit and meat knowledge and wisdom over time, because breastfeeding is not really the norm in our culture still, even though most moms start out breastfeeding. It’s not something that we’re all doing amongst each other with our sisters or aunts, or, you know, our mothers aren’t there to help us to show us the way. Right, it’s not happening all around and all of the workplaces and all of the commercial settings that we’re a part of, it’s hidden, it’s hidden under covers, it’s hidden with bottles of pumped milk, it’s hidden with staying at home, it’s hidden was going to the car to a nursing room to a restroom. Right? There’s all these ways that breastfeeding is still not in the public view.

And that’s okay, if you don’t want it to be in the public view. But then what I wouldn’t expect for us as mothers as a culture is for us to know how to breastfeed well, when there’s really very little example of breastfeeding going well, and being functional. Even the stock images of breastfeeding stock videos, things like that. Social media influencers who want to post about breastfeeding, I cannot tell you like, most of that is showing breast feeding dysfunction. And now that’s what we’re imprinting our minds with, we create a meme in our brains of looking to what other people around us are doing. And we think that if ours looks the same way that we’re doing it, right. Unfortunately, that’s just not true. I cannot tell you how many celebrities and influencers I see posting pictures of their babies latching at the breast and it is not a good latch. It’s not going well. You know, they give this advice. And it’s like, no, that’s not good advice, you know. And it’s frustrating for me as a lactation consultant, because what I don’t want people to think, is that there’s only one right way to breastfeed. But I will say this, for the most part, there is really only one right way to latch your baby, there are special circumstances. But that’s because something else is going on. And that should be troubleshot. Okay, and that should be fixed, so that you can get back to optimal breastfeeding. There are always always special circumstances, but that is not going to be very common. So let’s talk about getting the optimal latch for your baby.

The first thing that you want to do is either ditch that nursing pillow completely, or realize that the nursing pillow is not there to hold or support your baby at all. It’s not there for that the nursing pillow is there to support your arms in supporting your baby. Okay, now, before I get a bunch of hate mail and a bunch of haters, saying I love my nursing pillow, I couldn’t nurse without it. Maybe you’re one of those few people who’s using it properly. Okay, but probably what happens is, unfortunately, people end up laying the baby on the nursing pillow, so that they can have both hands to then hold the breast or do whatever else they’re trying to do and latch the baby, it’s going to be a recipe for shallow latch, it’s going to be a recipe for dysfunctional breastfeeding. So quite honestly, you have a built in nursing pillow when you are a new mom and you’ve just given birth, and that is your uterus that is still not back to its normal size.

So you will still have a distended abdomen that is there to support your baby. In fact, laying your baby on the fundus the top of your uterus after birth, help helps it to contract back to normal size, it helps build back your abdominal core strength, that sort of got shot to pieces by virtue of you being pregnant. And you’re supposed to engage those core muscles. And core is not just ABS by the way, it’s also your back. It’s also your pelvic floor. Okay, you’re supposed to be having good posture, and using your arms and your core to support your baby. Now, if you’ve had a C section, if you have carpal tunnel, whatever I’m not saying you’re doing it wrong, or you know, don’t rush things, right. Everybody’s got different circumstances, what I’m trying to describe to you as the ideal that we should be working towards. Okay, so you are supporting your baby in arms. I love to teach the cross cradle position, because you are going to leverage your baby’s reflexes in in the most easy way by using this position.

Pay and you don’t have to hold it forever, by the way. So cross cradle, if you don’t know is where your forearm is basically along your baby’s spine or their back and your hand is supporting the base of their head in their neck. And then your other hand is free. So we call it cross cradle because you’re kind of making a cross with your arm across your body. So if your baby’s feeding on the left breast you’re using your right arm to hold your baby. If your baby On the right breast, you’re using your left arm to hold the baby. I know this is an audio podcast. So if you don’t know what I’m talking about, literally just go to your favorite search engine and type in cross cradle position. And you will see many examples of this. Probably not examples only that I’m going to describe to you maybe well, so one thing you don’t want to do is hold the back of your baby’s head. You don’t want to do that, because that initiates a reflex for them to jerk their head backwards, and they are going to pull away from the breast. When they do that. They’re also going to be really, really frustrated, it doesn’t feel good. Now, if you put a hand on the back of your head, and you push it forward, how do you feel about that? Not too good, right? It actually is kind of triggering in some ways. If someone came up behind you and pushed your head, you’d turn around ready to smack someone, because it’s just a reflex pay, so it doesn’t feel good. Don’t do it to your baby, because your baby’s head needs to be tilted back. So there’s flexion, and there’s extension flexion would be if you’ve ever done your class, you’ve probably heard these terms. Flexion would be where your baby’s chin is to their chest. We’re never going to get a good latch that way.

So make sure that your baby’s head is an extension or their neck is an extension, and it’s tilted back. Okay, so we want the neck to be nice and open. This allows full opening of the jaw, it also allows full range of motion of the tongue. This is really, really important, this is a foundational piece that you cannot miss, no matter what position you’re using for your baby. This is one of the reasons why I don’t like football hold because most of the time the baby ends up with their head in flexion. And they’re never going to get a good latch that way. So neck and neck is tilted back head is tilted back pay and then their torso is against your torso, your baby should be hugged in tight to your body. The other reason for this is that it makes it kind of a no brainer or very easy to get their head in extension when their torso is tucked in because your breasts protrude from your body. So if your baby’s tucked into your torso, in order for their mouth to even come to the breast, they would have to tilt their head back because the breast sticks out away from the torso. Right so you can say tummy to tummy torso, torso, chest to torso, however you want to envision this, it just is going to depend on the length of your torso and anatomy and your your breast anatomy and all of that.

But the baby is tucked in their chest and tummy should be tucked in. This is why tummy time is really helpful for breastfeeding because your baby lays on their chest and their stomach and they get their head tilted back. That’s only going to reinforce good breastfeeding posture for your baby. Okay, you should not be leaning over you should not be hunched over your back should be straight, your shoulders should be relaxed, and your arms for the most part should not be winged out, they should be more at your sides. So you’re holding the baby with you’re like let’s let’s just pick a breast year, you’re gonna feed the baby on the left breast. So you’re holding the baby with your right arm. So your hand is cradling the base of their skull, and maybe your thumb and you’re sort of pinky and ring fingers, maybe even middle finger are kind of around the neck, the back of the neck and the base of the head. And then the palm of your hand is probably going to be right at the top of their back, right along their spine right along the center there. And then your forearm maybe follows the spine. And by the time it gets to your elbow, it’s more at your baby’s hips. I’m talking about a small baby, if you’re if we’re talking about a six month old, different size baby, it’s gonna be a little bit different. Okay, so you’re doing that, with your left hand, the free hand that’s not holding the baby, you will hold your breast. Now how many of you raise your hands I can’t see you. And this is recorded. But how many of you have been taught to make a C shape with your hand to sandwich the breast?

Okay, I know it’s a lot of you, even though I can’t see you. That is incorrect when you’re doing a cradle or cross cradle holes, or even if a bubbles, okay, totally incorrect. The reason for that is is that our mouths, your baby’s mouth is wide from side to side from corner of the mouth to corner of the mouth. So if we’re looking at our baby, as if they were standing up, right, that’s a horizontal line that connects the corners of the mouth. Now we turn the baby rotate them, let’s say 90 degrees on their side, that becomes a vertical line. Right? The width of their mouth is now up and down. It’s going from top to bottom. If you take your hand, and now you compress your breasts in a C shape, you’ve just compressed your breasts to form a horizontal line. Well what happens when we get a horizontal line and a vertical line together we get a plus sign that plus sign that is a mismatch. We want to have parallel lines that can match up and fit into one another. So you actually want to take your hand you want to make a U shape with your hand. So with your thumb and your fingers, you’re making a U and you’re holding the breast from underneath and then you are compressing the or gently sandwiching it gently squeezing it applying some pressure to shape your breast to firm up that area around right behind the nipple around the areola to make your baby get the most amount of breast tissue in their mouth that they possibly can. So remember this cradle cross cradle anytime your baby is laying on their side for breastfeeding, you are going to hold your breast from underneath and make a U shape with your hands. Now bonus points if you’re really struggling with getting a deep latch. Your areola is an excellent sort of bull’s eye or target if you will, not just for your baby visually but also for you. So when you’re doing this position, your thumb should be positioned just right at the edge of the areola or slightly behind it. If your thumb is on the areola, it is too close to the nipple and you’re going to deter your baby from getting a deep latch. I’ll explain why in just a moment. Your index finger which is in front of all of your other fingers should be very far away from the areola. It should be only on the breast tissue, probably about halfway back between your nipple and your chest wall.

So when you’re holding your breast like that, and a U shape that I’m describing, and your thumb is at the edge of the areola and your finger is a lot further back from the areola, you will notice that things are off center in terms of where your nipple is placed between your thumb and finger. That’s exactly what we want. We want an asymmetrical breast hold so that we can get an asymmetrical latch. Why? Because your nipple is supposed to be positioned at the roof of your baby’s mouth, which is called their palate. Your nipple is not supposed to be centered in your baby’s mouth. If your nipple gets centered in your baby’s mouth, it is now going to be either coming into contact or resting on your baby’s mid tongue. And whenever that mid tongue goes to elevate up to the palate up to the roof of the mouth, it’s going to be causing friction against the nipple, and now it’s going to be moving the nipple around in the mouth. And that is going to feel pretty uncomfortable for you. And if it doesn’t feel uncomfortable, you’re likely to get some sort of chiefing or championing or maybe scab Enos to that actual nipple tissue. But if we position her nipple right at the roof of your baby’s mouth, now your nipple is not getting rubbed by the breast. Now it’s not getting moved around in the mouth, it’s just staying in place where it’s supposed to be the entire duration of breastfeeding. Not only that, your nipple touching your baby’s palate stimulates their suck reflex.

So sometimes babies will route right the left side decide to open their mouths, right? Because they they continue that rooting reflex because they don’t feel anything contacting the roof of their mouth. The reason why babies who can’t latch end up preferring nipple shields or bottles is because there’s a protruded nipple that goes and touches the roof of their mouth and it stimulates their sock reflex. Your nipple is there really just to be an exit point for the milk from your milk ducts and to touch your baby’s palate. Nothing else. That’s the entire purpose of the nipple when it comes to breastfeeding. Okay, so back to you’ve got this asymmetrical hold on your breast. Right. Your index finger is positioned a lot further away from the areola. Now, when you’re holding your baby with your right arm and you bring them into the breast, there’s plenty of flesh of the breast for your baby’s chin and lower lip to come into contact with. If your baby’s mouth or chin comes into contact with the firm bones of your fingers, they will start to close down. It is the softness of the breasts that encourage your baby encourages your baby to latch and open wide and latch deeply. So remember that okay, if your fingers are touching your baby’s upper lip or their chin or their lower lip, you need to move them further back on the breast so that you don’t discourage your baby from opening wide. So your baby’s mouth is going to come to the breast. Right? The lower lip the chin are touching the breast your nipple is just under their nose. It is just above their upper lip.

Now the goal with latching is not to get your baby to latch on as quickly as possible. Nene. No no, no, no. The goal is to get your baby to latch as well as possible. I promise you they can wait another five or 10 seconds to latch no matter how much they’re crying. They can wait because they will feel better when they get the right latch. They don’t want just any milk. They also want breastfeeding to be this you know calming, comforting regulating experience. And when the latch is not good, it’s not a regulating experience. And I will talk about that more in just a moment as well but your baby comes the breast the the tongue sticks out this is going to happen very quickly. No way in any shape or form is happening as slowly as I’m describing it to you. But their tongue is going to go over the lower gums ideally over the lower lip or to the lower lip at least initially. And when they open wide throat be this little split second moment where your baby opens their mouth really wide. If you miss the tiny No big deal, they’re going to do it again as long as you’re keeping their chin to the breast. Okay, so their torsos tucked in their ear, shoulder hips are all in a straight line, they should not be turning their head to the side to come to the breast, they’re laying on their side, their torsos tucked in their chin is to the breast, you’re holding the breast, right, you are not moving. Imagine your back is velcroed to the seat behind you, and you are a statue and you cannot move.

That’s what I want you to imagine. You’re sitting up straight, you’re not hunched forward, maybe you’re even leaning back. Okay, but you don’t have to lean back to latch. I know, there’s all this hype about laid-back breastfeeding, we’ll get there. First, you got to match master the latch though, and you might not master it in a laid-back position. Especially if you’re larger breasted or have very sort of elastic breast tissue, it’s going to just be harder. And visually, it’s more difficult to see. So your babies, they’re opening, they’re closing their opening and closing thing may be a routine, there’s going to be a moment where you see their mouth stretch, and you see the corners of that mouth, go from having a crease at the corner to being rounded at the corner. And in that moment in that split second, your hand that is holding the back of your baby’s head and their upper back is going to swiftly quickly push your baby on to the breast. Not hard, not firm, not shoving your baby onto the breast, but it’s just gonna be this real quick. Like, right on. Okay, that’s what you’re gonna do. And if you miss the timing, no big deal. It’s okay can unlatch your baby and you can try again. But it’s all about a timing thing.

That’s the basics of getting a great latch explained to you in an audible way. And I hope that that’s helpful. It might not be you might need a visual and I’m working on it. I’m working on it. So you know, stay tuned. But sometimes this is like, you know, this could be accessible on your phone, if you’re listening to this. And you’re kind of pausing it, maybe even slow it down. Right as you’re trying this technique out. And I know some some of us are visual learners. But I also know some of us are audible learners audio audio learners. So if that’s you, this is probably going to be really helpful. So once your baby’s on how do you know they have a good latch? Well, one is pain free. Keep in mind though, that if you have had nipple trauma ongoing, and now you get a good latch, it will feel better. But it might not be entirely pain free just because your tissue is so sensitive to baby’s upper lip is relaxed, three corners of the mouth are against the breast for lower lip is completely flashed outward. Five, you can actually watch your baby’s tongue movement when they’re swallowing. So when your baby’s head is tilted back, this can be pretty easy to see, you might have to push back on the on the part of your breast that’s right against your sternum there just to get a good visual if you’re larger breasted. But you should be able to see behind the chin bone. But in front of the neck, there is a space there. And that space there is there’s no bone, there’s muscle, there’s flesh, there’s fat, right, maybe a cute little roll of your baby. Because they have cute little baby chunk and fat. Hopefully, not all babies do, though, just to be honest, and that’s okay. But that is the floor of their mouth. And you should see a rise and fall of the floor of the mouth.

And that’s going to actually indicate that there’s good tongue elevation or not. If you don’t see that if you see more movement at your baby’s jaw, more that the lips are opening and closing or that the jaw is opening and closing or that lower lip isn’t rolled out, then your baby is struggling with getting a deep latch maintaining a deep latch or elevating their tongue while they’re wide open. So a baby cannot, won’t do what they cannot do. So if your baby is tongue tied, maybe they can open wide to get the deep latch. But then once they’re on the bras because that tongue cannot elevate properly, they’re going to close their mouth down and go back to a shallow latch so that their tongue can reach the roof of their mouth. Because it’s tied. tongue tie has everything to do with tongue elevation doesn’t have a lot to do with how much they can extend their tongue out of the mouth or protrude it. It doesn’t have a lot to do with side to side motion of the tongue. Yes, it can impact those things. But what we’re really looking at is the elevation of the tongue. Remember, that’s what’s important for breastfeeding is that up and down motion of the entire, you know, mid to front of the tongue that needs to happen in order for breastfeeding to go optimally. Again, you may not experience immediate problems by virtue of your baby not having a great latch, but there will be issues down the road.

And maybe you’re maybe you have an oversupply, maybe your baby is just always able to get enough to eat and doesn’t have to you know, suck very hard or suckle very hard at the breast or do any of that and even past that 12 week mark your milk supply is maintaining all of that. But if your baby has a shallow latch one it’s harder to correct when they’re older. It’s easiest to do it when they You know under three months, definitely under a month is the easiest time. Let’s try and get it right from the start. If you’re pregnant listening to this, this episode is like absolute gold for you that I want you to like really, really ingrain in your in your mind. But without a deep laps without a breast that’s filling the baby’s mouth, your baby’s jaw, an oral and facial development will not go according to plan, it will not follow the genetic blueprint that they are born with. So external factors environmental factors influence our growth or development, our genetic expression, right? Muscle placing forces on bone is what grows bone tissue it is what grows the structure of the bone itself. So when we look at adults later on in life, who either let’s say we’re only ever bottle fed, or were tongue tied or something like that, not only do we see that they have very small Jaws deformed Jaws deforms, palates, deformed nasal passages, deformed orbits of the eyes, and these people often have a stigmatism, which is just basically a compression of the eyeball because of the misshapen orbits around the eyeball.

They have airway issues, right. They have upper airway resistance syndrome, they snore, they have sleep apnea, they have posture issues, things like that. Not only did their bone not grow in the right direction, but it also did not grow enough. So we can actually do scans of the bone to see as these people go through treatment to address these problems, like palate expansion, or, you know getting the job to grow and move forward with various orthodontic appliances. When they start getting the correct function, their tongue is moving in the right way, there’s enough room for the tongue, all of that, not only does the bone grow in the right direction, but we actually see that new bone grows. So much of our small face narrow face problem is not just that the jaw did did not grow to be nice and wide and broad. It’s that there was never even enough bone growing to begin with. So if the baby is forced to create suction in the breast rather than suckle and create a pressure differential at the breast, because of the latch because their tongue tied because of whatever other factor. And all, that baby not only has a smaller airway, a smaller entire lower face, potentially, you know impacting other things. They’re more prone to ear infections, because the Eustachian tubes that drain from the ears are now pinched off by the jaw not growing for it forward enough. So there’s a lot a lot of things that this can really impact especially the airway, right? Remember, the airway flows right down pass behind the mouth, right starts at the nose goes up, right? Well, the palate, the roof of the baby’s mouth, that’s actually the floor of the nasal airway. So if the palate is high, if it is not flattened broad, and the only way the palette really ever grows, flatten broad is if the baby has a good latch and is functionally breastfeeding. Right, so the breast fills the baby’s mouth.

And it actually kind of flattens and expands. That’s why have you create the U shape at the breast. So you’re actually shaping it much like it will shape to be shaped once it’s in your baby’s mouth. And that flattening of the fatty tissue of the breast and, and the milk ducts and whatnot, that actually filling their mouth grows that palate nice and broad and wide and flat. When that doesn’t happen when they’re just sucking on the nipple that’s pushing the palate upwards, or their thumb sucking or, or they’re using the wrong bottle or they’re using the pacifier too often, the palate collapses, and when the palate collapses, it’s two bones on, you know, side to side, left and right. And it collapses upwards. So it looks like a vaulted ceiling. Right, so becomes a vaulted palate. Well, when that happens, that vaults upward into the nasal passages. So babies with little tiny nostrils probably have high palates most of the time. And that can also cause a deviated septum. So right the septum is is that cartilage, that tissue between the left and right nostril. When it’s deviated, it’s because there’s not enough room for it to have that vertical growth. So it actually bends or sometimes breaks and sticks out to the left or sticks out to the right. Now this can also happen because of a nose injury or whatnot. But your your infant, your newborn, has probably not had an opportunity to break their nose yet. So we want to make sure that their nasal passages are forming properly.

That’s the beginning of the airway. If the nasal passages are too small, or they’re obstructed, your baby or your child or your adult child will begin to mouth breathe. And that’s very dysfunctional for a number of reasons. And if you don’t know I have plenty of podcast episodes where I’ve brought on some incredible, amazing, most intelligent, smartest minds in medicine to talk about the impacts of tongue tie and that sort of development. So, for all these considerations tongue tie or not, it’s incredibly important. It’s the foundation of breastfeeding in terms of making sure your baby gains weight while making sure that your milk supply is maintained, making sure you don’t get plugged ducts, mastitis damage to the nipple tissue, making sure that you don’t develop some sort of breastfeeding aversion because breastfeeding is a low lying level of uncomfortable or your nipple is getting hyperstimulated. Okay, it doesn’t have to be painful. But I see a lot of people not being able to nurse full term meaning to that two or three years that maybe they had that goal of doing because they actually develop a nursing aversion. Now this happens because there’s hyperstimulation of the nipple. And it’s just too much, right. Like after a few years of that of your baby, just nursing on the nipple, and constantly, you know, rubbing that with their tongues, your body’s like, you know what I am done.

But also, if your baby is struggling to get milk efficiently, right, if the flow is slowed, because they don’t have a good latch, because they’re preventing some milk from coming into their mouth, or they just can’t properly extract it in the bottles easier, they might develop a breast aversion, they might develop a bottle preference, you might end up using a nipple shield, there’s so many complications that can quite honestly stem from just getting a poor latch. And the other thing that I’ll say is that, I don’t think that tongue tie is over diagnosed. But I do think that there are people out there who are quick to blame tongue tie for the inability for the baby to get a good latch. And quite honestly, I do feel very, very strongly that before getting a tongue tie release, you should absolutely be working with an ibclc. This is kind of like that the argument of you know, like, if you’re going to go out and have drinks, you should plan on having someone else drive you home, get an Uber, get a lift, get a taxi, have a friend. And if you can’t afford that, then you probably shouldn’t be out, going out and getting drinks. Okay, now, that’s not to say that if you can’t afford a tongue tie release, or if you can’t afford an ibclc, you shouldn’t get a tongue tie released. It’s not the exact argument that I’m making. But what I am saying is that you will be throwing away money by going to get a surgical procedure, and not having the support of a skilled knowledgeable ibclc and bodyworker. In that process, that’s like going to get a hip replacement surgery and you never do physical therapy. So now you’re going to be stuck with scar tissue, you’re going to be stuck with muscle atrophy. And maybe you got that hip joint replaced, but everything else around it never got to heal and function properly. So you still don’t have the outcome that you’re supposed to have. Okay, so do not go through a tongue tie release without first working with an ibclc to rule out other issues, like a latch, a latch technique, a positioning problem, pay not everyone needs to use the latch technique that I just described to you. There are absolutely special circumstances.

But again, if you cannot let your baby in the way that I described, then there’s something else going on. Then there’s an underlying cause. It’s not that your baby has a recess job. Babies with recess jaws can latch in the way that I described to you. Most babies are born with a recess drop. But why is the jaw recessed to begin with? Why is it not grown forward far enough in utero? Was it in utero positioning? Was it a tongue tie? Or was it something else, we need to investigate these things and not rush out hoping that a procedure is going to fix it all. And I guarantee you that even if your baby’s tongue tied, Kate absolutely tied to the tip of the tongue lip tied buckle tide, the whole thing. And you don’t work with an ibclc ahead of time you don’t optimize latch, you don’t make sure that milk supply is not a factor. You don’t get things going as well as they possibly could ahead of time. Baby gets a procedure done. Now there’s pain that’s created in the mouth. Now the mouth is healing. Now the muscles are sore. Do you think your baby is magically going to know what to do with this newfound function? No, because their tongues never been able to move in that way before. So we’ve got to start retraining your baby, setting them up for success ahead of time. Now, that doesn’t mean you’re screwed, and that all is lost. If you didn’t do this, if you’ve got a tongue tie release, you didn’t know he didn’t work with an ibclc didn’t work on the latch first or working on latch as well as you could have or what have you. It’s not the end of the world. You’re not screwed. All hope is not lost, but work with one as soon as you can afterwards. Or if you’ve got the procedure done. You never saw any real benefit to it to it or not enough improvement. It’s never too late.

Work with an ibclc. The other thing that you want to be careful of is when you don’t get breastfeeding to be functional when you don’t get it to go well. Okay, and then you rely on a surgery to do that for you. Potentially, your baby might have some reattachment, right have some aberrant scar tissue that forms because we never got the rest of the structure up to speed. So you release the frenum but what about the muscles? What about the jaw? What about the baby posture, are they able to tilt their head back? Or do they have a neck preference like turning their head to one side, all of those things still need to be addressed. And the procedure to release the frenulum, a little band of collagen in the mouth is not going to fix all of those other issues. So I say tongue tie, because obviously tongue tie can cause some of the complications and things that I’ve talked about today. But just because you have those complications, doesn’t mean there’s a tongue tie. Maybe it’s just a latch technique issue. The other thing I’ll say is, that sometimes you’re going to try this latch technique. And all of a sudden, you got this great latch, and you’re like, oh, yeah, my baby’s not tongue-tied, hurrah. And then two days later, you can’t do it anymore, and your baby can’t do it anymore. Well, do the latch technique, try your best, but then get an ibclc involved. Because if you cannot keep get getting your baby to do the latch checking, and you’re doing all the right things, it’s no longer your fault. Okay, it’s not a you problem. It’s not your baby. It’s like, you need support to figure out what’s going on instead of chasing all these other solutions. So I could go on and on and on about this topic. But mostly what I wanted this episode to be for you was an audible description of how to optimize the latch to attempt to get the best slaps you possibly can for your baby, kind of how to know what’s a good latch, how to know when it’s not a good latch, and things to look for. So honestly, this is just one little piece of education in, you know, entire entire fields and you can kind of jump off from here to other episodes. Like if you want to learn more about ties. Check out the episodes I’ve done with pediatricians with dentist with osteopaths on this issue. They’re incredible, incredible resources. And, you know, if you have any questions, any other things you want to hear about maybe on this podcast, you know, reach out to me, send me an email, send me a direct message over on Instagram at holistic lactation, if you’re not following me there. I think now I’m up to like almost 30,000 followers, it’s nuts.

So I tried to respond to every message, I can no longer respond to every comment. Just to be totally fair, sometimes. Just they kind of get hidden and lost in just the delusion number of comments that I get. But direct messages I will certainly see. But follow me over there on Instagram, I’ve got so many great little, you know, post reels, IG TV videos, guides on Instagram, that I’ve put together, just for you. And if all that free content is not helping, don’t worry, I work one on one with people, I do virtual appointments. I’ve got an awesome online membership program coming so follow me on Instagram. So you can stay tuned with that I’ve got some online courses. So there’s a number of ways that I’m putting out more and more support there for anyone who needs it. So follow along. I can also always direct you to other amazing Instagram accounts to check out as well. And I so appreciate you listening to this episode. If you love the podcast, please head over to Apple Podcasts. leave a review with some comments. It helps us podcast get found by people who are looking for really helpful information on breastfeeding. So I’d love for you to do that and to share it with anyone that you think would benefit.


The latch at the breast is one of the most foundation pieces to breastfeeding. Getting a good latch from the start, or correcting it when it’s not good will be vital to you and your baby’s breastfeeding success. The host, Jacqueline Kincer, IBCLC, discusses why a great latch is important and how to get one on today’s show.

In this episode, you’ll hear:

  • Common pitfalls when latching
  • Why a good latch is important
  • What happens when you don’t get a good latch
  • How to get the best latch
  • What to do when this advice isn’t working