Is your breastfeeding latch great (or bottle if that’s your chosen method)? This is a little different to my usual blog musings. It’s a little close to heart for many of us working in the infant feeding realms you see, and we witness these things happen in our day to day work. Infant feeding is such an important part of our parenting journey and due to the cuts and lack of funding in infant feeding, this leaves so few people trained in basic breastfeeding support, let alone the complex stuff which comes up, parents are often left wondering what they might be able to do to improve their situation without the support to do so.
Facebook groups are full of peer support in the form of mum to mum groups offering words of encouragement, support and chat 24 hours a day which is great for moral support and a virtual hug at 3am when things are just exhausting, because somebody else is also on the twilight shift, trying to crack that perfect breastfeeding latch. What we also witness in these groups is parents and babies who need individualised support, face to face and from a specialist. One example, quite frankly a scary one, is to see parents of extremely underweight babies told to “just breastfeed, hun”, with no concern or request for review from a healthcare professional, breastfeeding counsellor or IBCLC.
What often happens far too frequently (just reading Facebook groups is enough to gather evidence on this) is that across the UK, no real assessment occurs, any of the parents concerns are not listened to and are often dismissed or trivialised, and you just have to continue because your baby’s latch is fine…….
More and more frequently we hear of peer supporters, Breastfeeding Counsellors, IBCLCs, midwives, health visitors and even dentists telling parents to “feed feed feed”. This information is all fine and well for a term baby who is drinking well at the breast and having frequent wet and dirty nappies and gaining weight. Feed the baby is always the first rule, but fed is not best as Dr Amy Brown discusses here………..
On the other end of the spectrum, blanket infant feeding information is not so ok when the opposite is happening and the signs parents are reporting show a baby who isn’t transferring milk as well as they could. What are parents to do? Where do they turn when they’ve already consulted *insert infant feeding person* and been told all is well when the actual evidence says differently?
Is baby drinking well and regularly – 8-12 times a day? Are you and baby comfortable and attaching well at the breast in a position that works for you?
Has anybody observed a full feed to check this and reassure you and explain how to recognise the signs your baby is transferring milk well? How many wet and dirty nappies? Are you and your baby getting sleep between feeds? Are their hands relaxed and open, and does your baby sleep after a feed?
As a general rule of thumb, a newborn baby in the first 6-8 weeks of life who is hydrated and feeding well will:
- have 6-8 wet nappies per day,
- a minimum of 2 dirty nappies per day (3/4 or more is also normal),
- show signs of relaxation (hands unclasped and floppy) towards the end of a feed,
- sleep well between feeds or remain peaceful and calm if they remain awake for a time afterwards.
Feeding plans written by lactation consultants are sometimes put in place where babies have a tricky start because of adverse birth situations, delay in milk coming in or anatomical issues like tongue tie or cleft palate. Where a large weight loss in the early days occurs, those short term combination feeding plans are valuable in protecting milk supply and reduce the risk of deydration and the problems that could occur. Pumping and breastfeeding, an element of topping up with expressed breastmilk or artifical infant milk can support the dyad when early signs of problems haven’t been recognised
Sometimes babies will be finger feeding and breastfeeding or bottle feeding, syringe feeding or using an SNS. A combination of all of these methods is sometimes used – which can be utterly confusing for somebody who isn’t trained in using supplemental support and may dismiss their validity.
Which qualifications are held by the people providing you with infant feeding support? There are several examples in other blogs about the difference between a peer supporter, a Breastfeeding Counsellor and a IBCLC. And even between all of those roles, there are vast differences across the country in the training and experience each individual may have. It is important to note that whilst some areas have specialist trained midwives and health visitors, many areas do not and parents with infant feeding problems should be referred to somebody who can assess infant feeding where a problem arises because it is not all about the latch.
As a new parent, you and your baby are learning, you are getting to know each other and how these things work for you personally. Knowing where to find the correct support for individual situations, tailored to you, as well as the basic information about infant feeding is important to your journey. As funds are cut and services are overstretched in maternity and community health visiting, it often results in nobody being qualified, no specialist training in infant feeding or assessment (and remembering that experience and training are not equal across the country). Throughout the training it is often relayed to us that should we see something that is beyond our remit, referral pathways to somebody else who can provide additional help should be the next step.
In an ideal world that’s how it should work…..instead a quick peek is had and parents are often told “you’re baby’s latch is GREAT!” because the subtle differences between a baby hanging out at the breast receiving very little and a baby feeding effectively are missed by the untrained or inexperienced eye. Parents then believe they’re doing all they can and when things don’t go to plan they have no explanation because somebody told them things were perfect.
Below you will find highlighted some of things we see and hear in our work with parents and babies in lactation support.
Your baby’s latch is great…..
- Your nipples look like a brand new Heather Shimmer and feel as though they may fall off if you ever feed your baby again, yet your baby’s latch is great.
- Your latch is great when you feel like a cheese grater is attached to your breast and you are convinced a vice would be less painful.
- Bleeding, agonising, lacerated nipples – your latch is great!!!
- Your baby’s red book shows slow or static weight gain, and baby’s latch is great.
- Your shoulders ache as your baby feeds for an hour and comes back to nurse again after a 15 minute break, the latch is great!
- Your baby hasn’t slept in the first 72 hours hours of life for more than 5 minutes at once, your baby’s latch is great.
- Your baby has slept soundly for 8 hours and fed 4 times today, your latch is great.
- You’ve seen no dirty nappies for 3 days, your latch is great.
- Wet nappies are few, but your latch is great.
- Five minute feeds and hour long naps before hunger strikes again, your latch is great.
- You’ve only eaten once today and had no rest between feeds, you’re doing great!
- After a big, wide attachment which you’ve nailed with military precision, your baby slips to the end of your nipple, and so your latch is great.
- No swallowing and lots of sucks, your baby’s latch is great.
- Nipple in babies mouth? Your latch is great!
From Alice: your breast is so swollen-full of milk that your nipple won’t fit in your babies mouth, but your latch is great.
You might recognise some of these scenarios or feel you’d like to add to this list, contact me if you’d like to add your own.
Finding the support you need can be difficult and sometimes confusing for new parents who are not sure who is and is not qualified to provide basic support or when things might need more specialist help. Some areas are a postcode lottery with infant services being cut and training stopped. There are some great places to find support across the UK from online resources, national breastfeeding helplines and asking parents for reviews of those services local to you. Effective feeding signs are the key to success, not what your breastfeeding latch looks like to somebody else.