24: Causes of a Difficult Latch

There is a long list of things that can get in the way of your baby having a good latch. Last week we dove into how the latch impacts the mechanics of breastfeeding, how it impacts your nipple comfort, and how it actually shapes your baby’s facial structures. In that episode, I mentioned that certain things need to be working smoothly in order to even achieve an optimal latch. Today we will talk about some of the things that can be a barrier to an optimal latch.

Before we begin, I want to very clearly say, that major difficulties are the exception. Not the rule. And I do not expect these. In general, I expect most babies, given the ideal set up, to latch and nurse pretty well. If there is an issue, which again I never expect, then get the right person to help so it doesn’t snowball.

Now let’s get into our list of latch messer uppers.

Okay first up is of course is restricted oral tissue. Such a hot topic. This is your tongue tie or lip tie which I believe is frequently misdiagnosed or potentially not the whole picture. But if you have a serious tissue restriction, impeding your ability to move important structures necessary for breastfeeding then of course it will impact breastfeeding. But it’s not the only thing that causes latch issues, and it’s dangerous to lump all shallow latched babies munching away at their mother’s nipples into this category.

So here are some other possibilities:

An over hungry baby. Oh man, this is so common but so overlooked! When was the last time you were hangry, overemotional, felt unsupported, and at the same time felt calm, organized, and able to smoothly knock out a well coordinated task that you have not fully mastered? Never? Okay me either. Calm you baby the best you can first. Use skin to skin, susshing, bob and weave, whatever you need to do. And next time- start before they are fussy.

Positioning is really important. We use our whole body and our alignment when eating and swallowing and it’s no different for babies. If a baby is not well aligned or lined up properly to latch, it can easily result in a shallow or not optimal latch.

Restrictions or tightness in body are often overlooked but play a big role in the ability to get in good alignment. You may see this in babies who nurse really well on one side but not the other. It may be obvious if they are always looking to one side which can be caused by tight neck muscles. But sometimes it’s more subtle, like perhaps tightness throughout the ribcage. These examples can impact not only the ability to get into a comfortable position to feed, but also the position and movement of jaw and base of the tongue which are important for feeding.

Micrognathia /mai-crow-nay-thee-uh/ is an undersized or small jaw. All babies are born with a slightly recessed or underdeveloped jaw, that’s normal and not what I mean here. If a baby has severe clinical micrognathia they may have it to the extent that achieving and maintaining a latch to sustain breastfeeding may be difficult.

Some craniofacial issues, such as a cleft palate, impede the ability to seal off the mouth while latched. This would mean that the baby wouldn’t be able to create the negative oral pressure needed for nursing. This can also happen with cleft lips, however, I have seen more than one baby with a cleft lip nurse very well with the right position or a little help from mom.

Reflux or other belly issues can really distract a baby from latching well. They may be upset (we already know that makes it more difficult). They may need to come on and off the nipple frequently, and just imagine food coming up as you are trying to eat and breathe. Not great.

A fast milk flow rate, especially for moms who have oversupply, can discourage a wide latch. I mean who wants to open wider to get milk out if it’s coming at you like a fire hose. If milk is coming too fast, babies may go on defense by gulping to keep up, pushing milk out of their mouth, blocking milk flow with their tongue, and even making their latch more shallow or clamping down (ouch!).

The last example I’ll give today is swallowing issues. It’s important for anyone to swallow safely because it is part of protecting the airway. Lots of compensatory strategies can come from a baby trying to protect their lungs and airway and avoid milk going down the wrong way. Purposefully adjusting their latch may be one of them.

Please keep in mind that sometimes more than one subtle thing may be going on at once when it comes to a non-optimal latch. If you know that something serious is going on- obviously I recommend you seek appropriate professional help. This episode is meant to empower you, not to have you chasing a white rabbit for weeks while underlying issues go unaddressed.

If what your sensing is more like okay this latch isn’t great but I don’t think it’s serious, just a little off sometimes, the here are a couple of ideas on what you can do:

First, start with the basics. Cast the big net that frequently resolves most latch issues. This means offering feedings ideally before your baby is fussy. This might mean more frequent feeds and not pushing them toward that simple spaced out schedule in whatever parent book was recommended to you.

Next, make sure they are in a good position, with proper alignment, so they can achieve an optimal latch. These two simple strategies of catching them at the right time and having proper alignment are simple but powerful.

If you want more detailed information on these important basics, check out episode 3 (where I explain how to set up each of your feeds), episode 4 (how much newborns eat), and episode 15 (to learn more about infant feeding communication).

If you prefer visuals and printable resources related to newborn feeding, you may want to look into my Infant Feeding Course which includes lots of examples of proper alignment, infant feeding cues, and normal feeding schedules for newborns. I will link to it in the description.

But listen, if you feel like something else is going on, then I encourage you to seek professional help 1:1. If you find the right person, they can help you create a specific support plan for you and your baby and ideally avoid any snowball issues.

I hope you don’t have any latch issues when you breastfeed your baby. I certainly don’t expect you to. But if you do, remember to try the basics and if they aren’t working or you want some support figuring out the missing piece- please get help. You don’t have to continue on, suffering and struggling alone.

And on that note- I’ll see you next week Mama!