#4 Nipples and the latch. Fitting mom and baby together!
So let's talk a little bit about breast and nipple shapes.
I have seen very large breasts with flat tiny areola and nipples~extremely small breasts with long everted nipples. I see nipples that point outward, nipples that point straight down, nipples that are the size of quarters in diameter! And nipples so extremely inverted that they wouldn't even extend into a pump flange or a nipple shield. Wouldn't it be nice if we all had perfect breasts/nipples for baby to latch onto, and produced a full milk supply. In reality, 28-35% of first mothers have issues related to flat, "shy", or inverted nipples. What can be done if you find you have flat or inverted nipples? Well, knowledge is power! You can start with knowing what type of obstacle you may face with nursing your baby. Ideally a prenatal appointment with an IBCLC where she can review any pertinent medical history, and examine your breasts and nipples.
Now you will know what you need to do sometimes before delivery, and mostly after baby comes.
***Please DO NOT "toughen" your nipples up by any means that any misinformed person may advise you! Bad advice!***
In previous years lactation consultants recomended that moms with flat nipples wear "breast shells" inside their bra to help their nipple evert, but research hasn't supported this claim. I like breast shells for sore nipples. They are like a protective covering keeping anything from rubbing against them. After delivery, you can use a breastpump for 3-5 minutes to help nipple extend and everted so the baby can feel it. I've also heard of holding ice against the nipple to get it cold and therefore everted. There is a product on the market called "Latch Assist."
It basically does the same thing as a breast pump, but it is small, so you can take it with you when you're out and about.
Supplecups are small silicon cups that you wear before delivery to help train your nipples to evert rather than stay flat or go inward. Click on the link and learn more about them!
With the help of an IBCLC we will use our "tricks of the trade" to attempt a latch...sometimes it works, sometimes it doesn't; that's when I wish I had a magic wand! 🤨 Under the direction of an IBCLC, there are times when the only possible way to get mom and baby to match up and latch on to the nipple is the use of a nipple shield. This breastfeeding tool often brings baby right to breast when all other strategies haven't worked. Especially if baby has been given bottles pumped milk or formula. The nipple shield is the "stepping stone" between bottle and the breast!
(It is imperative to know how to apply it correctly, and use the correct size~Most Mothers needs Medium!! Fit the mother's nipple, not the size of baby's mouth.
the video link below reviews the most common reasons for using a nipple shield.
Latching Using a nipple Shield
If latching is becoming increasingly painful throughout the entire feeding, not just the initial 30 seconds
(which can be common for the first 1-2 weeks) If her nipples are bruised, cracked, or bleeding
it can be very difficult to tolerate breastfeeding.
Many mothers start dreading the next feeding, and that's not what breastfeeding should be like.
You may need to stop feeding from the breast, and pump for 1-2 weeks until the nipples heal.
When I see a new mother who has been dealing with painful latching my first assessment is to watch her latch the baby, in many circumstances the latch actually appears good. Often I can help her adjust the baby and mother into a more comfortable and supportive position,
that also feels much better for mom!.
What needs to happen after my exhausted efforts have not led to a comfortable latch? What's next? A more extensive oral evaluation by the infant's pediatrician or an LIP specializing in ankyloglossia and lip tie diagnosis and treatment if found necessary. The provider should examine the palate, the suck, the upper lip frenulum and under the tongue from the appropriate approach. Please remember that all of this evaluation is only a part of the screening. It is vitally important to look at the entire breastfeeding story! Not just the anatomy or how the suck "feels." After diagnosis by a Licensed Independent Practitioner,
(Pediatrician, ENT, Pediatric dentist)
you, as the infant's parent will ultimately make the decision to move forward with a frenectomy, or to do nothing. It is important to note that many babies who benefit from a frenectomy, may also benefit from several sessions of bodywork such as cranial sacral therapy and infant chiropractic therapy in order to experience the full benefits of a frenectomy or frenotomy.
#4 Expecting mothers who plan to breastfeed should take a breastfeeding class AND schedule an appointment with an IBCLC (Lactation Consultant) to discuss your health history, and have their breasts and nipples examined for possible hurdles that we can make a plan for breastfeeding success. knowledge is power! If you don't know where to find an IBCLC please go HERE
I have seen very large breasts with flat tiny areola and nipples~extremely small breasts with long everted nipples. I see nipples that point outward, nipples that point straight down, nipples that are the size of quarters in diameter! And nipples so extremely inverted that they wouldn't even extend into a pump flange or a nipple shield. Wouldn't it be nice if we all had perfect breasts/nipples for baby to latch onto, and produced a full milk supply. In reality, 28-35% of first mothers have issues related to flat, "shy", or inverted nipples. What can be done if you find you have flat or inverted nipples? Well, knowledge is power! You can start with knowing what type of obstacle you may face with nursing your baby. Ideally a prenatal appointment with an IBCLC where she can review any pertinent medical history, and examine your breasts and nipples.
Now you will know what you need to do sometimes before delivery, and mostly after baby comes.
***Please DO NOT "toughen" your nipples up by any means that any misinformed person may advise you! Bad advice!***
In previous years lactation consultants recomended that moms with flat nipples wear "breast shells" inside their bra to help their nipple evert, but research hasn't supported this claim. I like breast shells for sore nipples. They are like a protective covering keeping anything from rubbing against them. After delivery, you can use a breastpump for 3-5 minutes to help nipple extend and everted so the baby can feel it. I've also heard of holding ice against the nipple to get it cold and therefore everted. There is a product on the market called "Latch Assist."
Supplecups are small silicon cups that you wear before delivery to help train your nipples to evert rather than stay flat or go inward. Click on the link and learn more about them!
With the help of an IBCLC we will use our "tricks of the trade" to attempt a latch...sometimes it works, sometimes it doesn't; that's when I wish I had a magic wand! 🤨 Under the direction of an IBCLC, there are times when the only possible way to get mom and baby to match up and latch on to the nipple is the use of a nipple shield. This breastfeeding tool often brings baby right to breast when all other strategies haven't worked. Especially if baby has been given bottles pumped milk or formula. The nipple shield is the "stepping stone" between bottle and the breast!
(It is imperative to know how to apply it correctly, and use the correct size~Most Mothers needs Medium!! Fit the mother's nipple, not the size of baby's mouth.
the video link below reviews the most common reasons for using a nipple shield.
Latching Using a nipple Shield
If latching is becoming increasingly painful throughout the entire feeding, not just the initial 30 seconds
(which can be common for the first 1-2 weeks) If her nipples are bruised, cracked, or bleeding
it can be very difficult to tolerate breastfeeding.
Many mothers start dreading the next feeding, and that's not what breastfeeding should be like.
You may need to stop feeding from the breast, and pump for 1-2 weeks until the nipples heal.
When I see a new mother who has been dealing with painful latching my first assessment is to watch her latch the baby, in many circumstances the latch actually appears good. Often I can help her adjust the baby and mother into a more comfortable and supportive position,
that also feels much better for mom!.
What needs to happen after my exhausted efforts have not led to a comfortable latch? What's next? A more extensive oral evaluation by the infant's pediatrician or an LIP specializing in ankyloglossia and lip tie diagnosis and treatment if found necessary. The provider should examine the palate, the suck, the upper lip frenulum and under the tongue from the appropriate approach. Please remember that all of this evaluation is only a part of the screening. It is vitally important to look at the entire breastfeeding story! Not just the anatomy or how the suck "feels." After diagnosis by a Licensed Independent Practitioner,
(Pediatrician, ENT, Pediatric dentist)
you, as the infant's parent will ultimately make the decision to move forward with a frenectomy, or to do nothing. It is important to note that many babies who benefit from a frenectomy, may also benefit from several sessions of bodywork such as cranial sacral therapy and infant chiropractic therapy in order to experience the full benefits of a frenectomy or frenotomy.
#4 Expecting mothers who plan to breastfeed should take a breastfeeding class AND schedule an appointment with an IBCLC (Lactation Consultant) to discuss your health history, and have their breasts and nipples examined for possible hurdles that we can make a plan for breastfeeding success. knowledge is power! If you don't know where to find an IBCLC please go HERE
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