When Your Baby Doesn't Latch
There are many reasons why a baby won’t latch or has stopped latching. It is a good idea to get professional help from an IBCLC when coaxing your baby back to the breast. There are many strategies that can be helpful in achieving a latch. It can take time, patience and weeks of practice to get the baby back to exclusive breastfeeding, but it can happen. Plan on seeing baby steps like one better a day for a few days and then 2 better feedings a day for a few days and so on. There may even be set-backs, but consistently using the following strategies can gradually bring the baby closer to exclusive breastfeeding if that is your goal.
While you are working on getting your baby to the breast, follow the two golden rules of breastfeeding.
1. Feed the Baby. This probably sounds like a no-brainer, but still needs to be said. Make sure your baby is getting adequate amounts of milk using finger feeding, cup feeding or paced bottle feeding methods. If you are not sure how much your baby should be eating, ask a lactation consultant.
2. Preserve your milk supply. Pump as often as the baby eats to maintain your milk supply.
Offer breast while baby is in a quiet, and calm state.
Watch for the early signs of hunger and offer the breast using techniques your lactation consultant has shown you. Your baby is more likely to refuse the breast in a crying or frustrated state. If you have tried offering the breast and mom or baby gets frustrated, take a moment to reset with skin-to-skin or other methods that work for mom and baby. If the baby is too hungry, offer a small amount of supplement and try again. We want time at the breast to be a happy time so that the baby does not develop an aversion to the breast. Another way to try is with a sleepy baby. Waking the baby and offering the breast in a sleepy state can also be helpful.
Offer an immediate reward of milk
Pump, hand express or try reverse pressure softening to elicit a let-down before trying to latch your baby.
Skin to Skin
Practice skin-to-skin contact with the baby as often as possible. Removing the baby’s clothing and placing them on mom’s chest can trigger nursing reflexes. When a baby is ready to eat, you’ll notice that they will lunge and bob their head on mom’s chest. This is a sign the baby is ready to eat and looking for mom’s nipple. Some baby’s will eventually self-attach in this position. Spending lots of time skin-to-skin with mom will create calm and happy associations at mom’s chest. This brings you a step closer to latching.
Baby Wearing
Baby wearing is another way to keep baby close to your chest. Wear a tank, low cut top or no top at all to create more happy associations with your chest. The sight, smell and feel of mom’s chest should evoke happy or content feelings in the baby.
Rebirthing
This is essentially taking a warm bath with the baby. Start with bath water near body temperature. Use a bath thermometer to get to about 99 degrees. Keep lights low and have a helper there to hand you the baby after you get in. Skin-to-skin in a warm bath can sometimes reset the baby and the baby may search for the breast as they would have immediately after birth.
Bait and Switch
This method has you feeding the bottle very close to the breast. After the baby has taken a few sucks from the bottle, quickly switch the baby over to mom’s nipple.
Nipple Shield
Babies that have developed a preference for the bottle can sometimes be coaxed back to the breast with a nipple shield. Sometimes the nipple shield can even be placed over the bottle nipple for bottle feedings to get the baby accustomed to the shield. It is important to work with a lactation consultant when using a shield this way.
Finger Feeding
This is a method of feeding using a very thin feeding tube taped to an adult’s finger. When the baby sucks on the finger with the feeding tube, milk is drawn out of a container of milk. This feeding method is more like breastfeeding and trains baby to use similar tongue motions and jaw movements needed for breastfeeding. This helps train the baby’s suck and improves sucking skills over time. Baby gets used to soft tissue rather than silicone. This can also be used to transition from a nipple shield.
Paced Bottle Feeding
Babies often develop a preference for the fast flow from a bottle. While you are working on getting the baby back to breast, it is important to make bottle feedings more like breastfeeding. Use a premie nipple to slow the flow. Feed in an upright position, holding the bottle horizontally. Initiate the feeding by teasing the baby’s lips with the bottle nipple and wait for the baby to open wide. Bring the baby towards the bottle instead of bottle to the baby. Babies take natural pauses while breastfeeding. Replicate those pauses after every few sucks by tipping the bottle down and then back. Watch this video for a demonstration.
Stand, Bounce, Rock, Sing
Gently bounce while sitting on a balance ball or standing after the baby has latched to keep them attached to the breast. Talk softly and sing to the baby to provide positive feedback. Babies love the sound of their parents soft voice and often respond positively while nursing.
Whatever strategies you use, be consistent. Ask a lactation consultant for help. Your lactation consultant can check oral structure and function. She may give you functional exercises to help with latching. She may help with positioning for a better latch. You should get a support and a care plan to follow that will guide you to meeting your breastfeeding goals. Contact me with your questions or book an appointment to see me in person or online.
Georgina Lile is an In-Network Provider for Aetna
Many Aetna plans cover up to 6 visits with a lactation consultant if you need support with breastfeeding or a prenatal breastfeeding class; with no out-of-pocket cost to you.
During the Covid-19 pandemic, Aetna is covering virtual lactation care from an in-network provider like myself at no cost to you.
She also accepts some Blue Cross Blue Shield, Cigna and United Plans through Lactation Network. Coverage varies.