A Good Latch and Breastfeeding Tools (Nursing)

by Jacquelyn McMillian-Bohler

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    00:01 Now I want to talk to you about latch.

    00:04 Because making sure the baby is well-latched is super important and not only to encourage breastfeeding, because if the baby's not latched on well, you can cause blistering and nipple trauma.

    00:14 But also, if we don't have a good latch, we don't get good suckling.

    00:19 And why do we need the suckling? Exactly, to release the prolactin.

    00:23 So I want to show you what a good latch looks like.

    00:26 So if you see on my nipple here.

    00:28 We've got an erect nipple.

    00:30 We want to make sure that we introduce the breast into the baby's mouth.

    00:35 Now in this case, the baby's mouth is already open.

    00:38 But we want to make sure the baby's mouth is wide open like an 'O' before we tried to introduce the breast.

    00:44 If the baby's mouth is closed, and we try to stuff the nipple into the mouth, then that's not going to facilitate a good latch.

    00:52 Also, we want to be careful about where we touch the baby's face.

    00:56 Because the baby has a reflex.

    00:58 Remember, the rooting reflex we talked about in newborn assessment.

    01:03 Anywhere we touch the baby's face, the baby's going to move their head.

    01:07 So if I'm trying to get the baby into a cradle hole, like this, and then I'm touching the baby's cheek like this, where's the baby's head gonna go? That way, which is the opposite of where I want.

    01:19 So if I want the baby to turn their head in, that I need to touch the cheek that's close to where the breast is.

    01:25 Okay, so good latch, I'm gonna make sure the baby's mouth is open.

    01:29 I'm going to introduce the nipple.

    01:31 I'm going to let the baby munch down like a Pac-Man, and inside, and that's what it looks like.

    01:38 So if you can see from this picture, the nipple is actually pulled all the way into the baby's mouth.

    01:44 So if it's right on the edge, then that little nibble with those gums is going to be really painful.

    01:49 And it's going to produce blisters, which is going to make breastfeeding really uncomfortable for the birthing person.

    01:55 You'll also notice sound with a good latch.

    01:58 If we have a good latch, you're going to hear the baby swallowing either the colostrum or the mature milk.

    02:04 But if there's a poor latch, it's gonna sound like a smack.

    02:10 So smacking is not good because that means there's a poor latch.

    02:15 Speaking of poor latch, I want to make a point about the nipple anatomy and the variations that we can have.

    02:22 So in this case, what you notice about the nipple is that it's erect.

    02:24 So it's sticking out like this.

    02:27 If we have a situation where the nipple is not sticking out, so let's say the nipple is flat, can you see that? You can imagine that it would be a little bit more difficult for the baby to latch on.

    02:38 And that could be made even more difficult if we have an inverted nipple, where the nipples actually almost inside like this.

    02:45 So we actually have to work on getting that nipple pulled out in order for the baby to have something to latch on to.

    02:52 And in this case, wearing a nipple shield might be a solution to help that happen.

    02:58 So now let's talk about some tools we can use to actually supplement breastfeeding when it's a little bit more challenging or difficult.

    03:05 Now everyone cannot produce milk, and everyone doesn't decide to breastfeed.

    03:10 But everyone and every baby actually can have donor milk.

    03:14 Most facilities and hospitals offer a donor milk program, we only have to ask.

    03:19 So make sure that your clients know that donor milk is available if they need or want that option.

    03:25 We can also expressed milk, either by hand or by pump, and we can give the baby the breast milk in a bottle.

    03:32 If perhaps the birthing person is making milk, but maybe not enough milk to meet the demand of the baby, we can actually supplement a little bit of formula to go along with the breast milk, not letting go of the breast milk but adding to.

    03:47 We can also think about babies that maybe have a poor sup reflex or maybe a baby that needs to use less energy in the eating process.

    03:56 We can do finger feeding or we can do syringe feeding to actually make that process a little bit easier.

    04:01 So we add the breast milk to a syringe and then slowly introduce that milk into the corner cheek of the baby's mouth.

    04:09 And then they're going through the process otherwise of sucking and drinking the breast milk.

    04:15 We can use breast pumps that either are handheld or we can use electric pumps.

    04:20 Now often in the hospital we have what are called hospital grade pumps, which have actually a pretty strong vacuum system a lot stronger than home systems.

    04:29 So if you have a client that's going to be breastfeeding at home maybe to supplement feedings or is having some difficulty producing milk.

    04:37 Then we might want to recommend an electric hospital grade pump because it works a little bit better.

    About the Lecture

    The lecture A Good Latch and Breastfeeding Tools (Nursing) by Jacquelyn McMillian-Bohler is from the course Newborn Nutrition (Nursing).

    Included Quiz Questions

    1. Flat
    2. Inverted
    3. Everted
    4. Low
    5. High
    1. Syringe
    2. Donor milk
    3. Expressed milk
    4. Breast pump
    5. Baby food

    Author of lecture A Good Latch and Breastfeeding Tools (Nursing)

     Jacquelyn McMillian-Bohler

    Jacquelyn McMillian-Bohler

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