Breastfeeding

Ineffective Latch-On or Sucking

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Causes of Problems | Signs of Problems | How You Can Help the Process | Feeding Devices | Contact Us

Proper breastfeeding takes time.

During breastfeeding, a baby must be able to remove milk from the breast well. He / she has to get enough milk to gain weight. A baby's sucking also "tells" the breasts to increase or maintain milk production. Poor milk removal can cause problems with weight gain because the baby is not getting enough milk. Poor milk removal will be followed by a drop in the amount of milk being produced for the baby.

Different things affect how well a baby can suck and remove milk from the breast. Some babies have problems staying awake. Others have problems trying to suck, swallow and breathe like they should. Some babies have conditions that affect the structure of the mouth which makes feeding difficult. Potential causes of suck or latch-on problems include:

Prematurity
Labor and delivery medication
Down syndrome
Jaundice
Infection
Cardiac defects
Tongue-tie
Cleft lip or palate

It is important to know the signs that a baby is not removing milk from the breast well. Steps can be taken to correct any problem. Signs of ineffective sucking may include the following. The baby who consistently:

Does not wake on his / her own to cue for feedings eight or more times in 24 hours
Latches on and then lets go of the breast repeatedly
Falls asleep within five minutes of latch-on or after sucking two or three minutes
Does not suck regularly for the first seven to 10 minutes of a feeding
Feeds for more than 45 minutes without acting satisfied or full after a meal
Produces fewer than two stools in 24 hours by the end of the first week (for the first four to eight weeks)
Produces fewer than six soaking wet diapers in 24 hours by the end of the first week

The mother who:

Has persistent sore or bruised nipples or areola
Develops red, scraped or cracked nipples
Has creased or flattened nipples after feedings
Does not have breast fullness before feedings and does not have softened breasts after feedings
Has more than one episode of plugged ducts or mastitis

How you can help with the breastfeeding process:

Feeding problems can be upsetting but most babies will learn to breastfeed if given time. It is important to work with the baby's doctor and your lactation consultant (IBCLC) for latch or sucking problems. There are things you can do to help breastfeeding progress. You also need to make sure your baby is getting enough to eat. Always ask your baby's doctor if you have questions.

Wake the baby to breastfeed every three hours.
Know that your baby will do better at some feedings than others.
Sometimes your baby will need more time to "get going" at the breast.
Massage your breast toward the nipple during feedings. This will deliver milk into the baby's mouth when he / she begins to fall asleep too soon.
Chart the number of wet and dirty diapers on a daily record. Write down the amount and color of stools.
Use a hospital-grade, electric breast pump to develop or maintain a milk supply. Express milk after breastfeeding.
Offer supplements of expressed breast milk as directed. Talk to your baby's doctor about using banked donor milk or formula if you do not have enough milk to feed your baby.
Sometimes there are differences in the way a baby's mouth is formed that need treatment. These variations in the mouth can make breastfeeding hard for a baby. Treatment may involve oral exercises taught by an occupational therapist. Treatment can also involve surgery to correct a defect.
Certain feeding devices and methods may help with proper sucking. They are used to give your baby milk during the "learning to breastfeed" process. Feeding devices have advantages and disadvantages. A certified lactation consultant (IBCLC) can help you decide if a device or method is right for your baby.
- nipple shield
  A thin shield is placed over the nipple during feedings for some babies. Nipple shields have been shown to encourage better latch and sucking patterns in certain cases. They can help a baby take more milk from the breast.
- feeding tube system
  A feeding tube system may be taped to the breast or a finger. The baby receives milk through the tube when the baby sucks. These devices are used to give extra milk to a baby who can't get enough milk from the breast.
- alternative feeding methods
  There are other feeding methods that can be used to make sure your baby is getting enough milk. Some may be less likely to cause problems with breastfeeding. These include cup-feeding, syringe-feeding, spoon-feeding, or (eye) dropper-feeding. If using a bottle, bottle nipples with a slower rate of flow are preferred.
  Keep thinking positive. It is normal to get frustrated and think your baby will never learn to breastfeed. Spend time with your baby skin-to-skin when not feeding. Skin-to-skin contact can help the baby get to the breast sooner. It also helps to maintain milk production.

Get support. Stay in contact with your lactation consultant. You may also want to contact a mother's support group such as La Leche League. Your network can help provide information and the moral support you need.