Latching on at the Breast
QUESTION
Dear Lactation Consultant,
My little boy was born on 1/25. We had some difficulties in the hospital getting him to latch on properly and stay there to nurse. He apparently likes to have his tongue on the roof of his mouth. While we were there, the lactation consultant tried to help us out on a couple of different occasions. We ended up having to finger feed him with a syringe and thin tube the colostrum I had pumped.
She also gave me a nipple shield, but we didn't have much success with that, so we didn't use except for 1 time. When we got home (1/27) he was still having a hard time latching and staying there, but it seemed to improve every time. He was doing well Sunday through Wednesday, when for no apparent reason on Wednesday night, he screamed and cried every time I tried to put him to my breast. We tried every trick the LC and labor nurses suggested. Nothing worked.
We ended up finger feeding him the milk I had just pumped (so we know it wasn't the milk that was bothering him). Anyway, this continued (and still continues) for the rest of the feedings that week. I called the LC back and explained the situation to her and she said that he wasn't getting enough calories through finger feeding (something that is only supposed to be done within the first few days of life) and that I should give him a bottle of breast milk. We still try to latch him before we give him the bottle, but she said if it doesn't work after 15 minutes, to just give him the bottle.
Is there any way we can get him to "re-learn" how to latch on? I really want to nurse him, but I'm having to pump just as much as I should be nursing in order to keep my milk supply up as much as possible (which I'm afraid is going to diminsh soon, too). Do you have any ideas or suggestions as to why this happened or what we can do to change it?
Thank you,
Anne
ANSWER
Hi Anne,
I'm sorry to hear that you are having such a rough start. But I think it's great that you are hanging in there with pumping. Let's see if we can get you back on track.
First of all, let's start with protecting your milk supply. Are you using a hospital-grade electric pump? If you don't have one, I'd strongly advise you to rent one for the next month or so. Your hospital probably has a place where you can rent one. If not, call the Medela tollfree number (1-800-tell-you), type in your zip code and it will tell you where to rent a pump in your community.
Get the double pump kit. And be sure to empty your breasts 8-12 times a day. We have some more specific instructions on BreastfeedingMadeSimple.com. Go ahead and give your baby your milk via bottle or finger feeding. Right now, let's just concentrate on feeding the baby.
Second, I'm confident that we can get your baby back to the breast. But you need to take your time. Sometimes, if babies have experienced frustration at the breast, they may not want to be there -- especially when they are very hungry.
So what you want to do now is keep him near you when he is not hungry. Sit with him on your chest, skin to skin. Put him upright between your breasts and just hang out with him. Babies can often start their breastfeeding behaviors all over again from this position, even if they have had a tough start. If he bobs down to the breast, gently support him and see if he latches on (he just may).
In the meantime, he's learned that the breast is a nice place to be. Another strategy that you might try is laying down with him and letting him hang out near your breast while laying down. That can work well too.
Keep an eye out for his early hunger cues: smacking, putting his hand to his mouth, licking. That's a good time to try him at the breast. Try not to wait until he is crying.
If he is still having trouble nursing, give him your milk in a bottle/feeder. And just keep hanging out with him.
Please keep me posted on how your are doing. And try not to be discouraged! I know the two of you can learn how to do this.
-- Kathy Kendall-Tackett, PhD, IBCLC
Kathleen Tackett
Dr. Kendall-Tackett is a health psychologist, International Board Certified Lactation Consultant, and Research Associate Professor of Psychology specializing in women's health at the Family Research Lab, University of New Hampshire. She is a Fellow of the American Psychological Association in both the Divisions of Health Psychology and Trauma Psychology. Dr. Kendall-Tackett is a La Leche League leader, chair of the New Hampshire Breastfeeding Taskforce, and the Area Coordinator of Leaders for La Leche League of Maine and New Hampshire.
Dr. Kendall-Tackett is author of more than 140 journal articles, book chapters and other publications, and author or editor of 15 books including The Hidden Feelings of Motherhood (2005, Hale Publications), Depression in New Mothers (2005, Haworth), and Breastfeeding Made Simple, co-authored with Nancy Mohrbacher (2005, New Harbinger). She is on the editorial boards of the journals Child Abuse and Neglect, Journal of Child Sexual Abuse and the Journal of Human Lactation, and regularly reviews for 27 other journals in the fields of trauma, women's health, interpersonal violence, depression, and child development. Dr. Kendall-Tackett is the "Ask a Lactation Consultant" columnist on Pregnancy.org and serves on the Board of Directors of Attachment Parenting International.
Dr. Kendall-Tackett received a Bachelor's and Master's degree in psychology from California State University, Chico, and a Ph.D. from Brandeis University in social and developmental psychology. She has won several awards including the Outstanding Research Study Award from the American Professional Society on the Abuse of Children, and was named 2003 Distinguished Alumna, College of Behavioral and Social Sciences, California State University, Chico.
