The ultimate guide on how to fix a shallow latch
You’re a breastfeeding mom and you’ve been struggling with raw, damaged or sore nipples. You don’t know what’s going on, but someone somewhere mentioned that your baby has a shallow latch, whatever that means. But what can you do about it?
Before you reach for a nipple shield that so many people recommend, rather seek the correct information and support to fix the problem completely. Sure, you can use nipple shields, creams and ointments or you can get laser therapy, many of these are great options to help with the treatment of damaged nipples. But it’s not addressing the cause of the damaged nipples, so it’s not solving the problem.
The real question should be, how to correct the cause of a shallow latch when breastfeeding.
What is a shallow latch?
A shallow latch is when a baby latches onto the nipple, often called nipple feeding and not onto the breast.
A shallow latch is when a baby doesn’t open their mouth wide enough or does not position their tongue correctly to take in enough of the areola (the darker area around the nipple) when breastfeeding.
There are many factors that can influence the process of latching a baby onto the breast. Many of these factors can cause a very painful latch.
How does the latch and milk removal process work?
- A large part of the areola and the tissues underneath it, including the larger ducts, are in the baby’s mouth.
- The breast is stretched out to form a long ‘teat’, but the nipple only forms about one third of the ‘teat’.
- The baby’s tongue is extended over the lower gums, beneath the milk ducts (the baby’s tongue is in fact cupped around the sides of the ‘teat’.
Babies should suckle from the breast and not from the nipple. - As the baby suckles, a wave passes along the tongue from front to back, pressing the teat against the hard palate, and pressing milk into the baby’s mouth from where he or she swallows it.
Babies use suction mainly to stretch out the breast tissue and to hold it in their mouth. The oxytocin reflex makes the breast milk flow along the ducts, and the action of the baby’s tongue presses the milk from the ducts into the baby’s mouth. When a baby is well attached his mouth and tongue do not rub or traumatize the skin of the nipple and areola. Suckling is comfortable and often pleasurable for the mother. She does not feel pain.
Factors that influence the latch
Breastfeeding may be natural for humans, but that doesn’t mean it comes without practice or complications. Like I always say, breastfeeding may be natural, but it’s still a learned skill, just like crawling and walking.
For some, there may be more anatomical or health complications at play. The good news is that there is almost always something you can do to achieve a deeper and pain free latch.
There are many factors that can influence the latch including positioning, poor latching technique, oral function issues such as a lip tie or a tongue tie, medical issues in either the mother or the baby and anatomical reasons such as inverted nipples or very big nipples.
Signs of a good latch
Proper positioning
You and your baby are tummy to mummy, their shoulders, back and hips are well aligned in a straight line. Your baby’s nose is lined up with your nipple to encourage them to open wide. Most importantly, you’re both comfortable during the feeding.
You’re baby’s mouth is wide open
You will be able to tell that their mouth is wide open. It’ll look like their mouth is stuffed with the breast. Almost like a cute little chipmunk.
There’s no cheek dimples
When your baby’s mouth is wide open and they’re latched onto enough breast, there won’t be any dimples on their cheeks, their cheeks will be nice and rounded.
Their nose is close to your breast
Anatomy differs and nose position will look different for every breastfeeding dyad, but your baby’s chin should be closer against the breast than their nose. Remember, they use their jaw to extract milk from the breast too.
Neutral upper lip
It’s commonly said that the upper lip should be flanged out, but this isn’t true for all dyads. It should be neutral and relaxed to form a proper seal.
Flanged out bottom lip
The lower lip is usually flanged out if the baby has a deep latch.
Your baby’s tongue is extended over the bottom gum ridge
Your baby’s tongue should always be extended over their lower gum ridge, this is how they extract milk from the breast. If their latch feels choppy, it’s definitely a shallow latch.
You are comfortable and pain free
The most important sign of all is a comfortable latch. You’re comfortable and pain free during and after feeding sessions.
Anatomy looks different for every breastfeeding mother and baby; each latch will look different. What may be normal for one dyad may not be normal for another dyad.
Being comfortable and pain free is a great sign. Although it’s important to note that you can sometimes be comfortable and pain free with a shallow latch too.
Signs of a shallow latch
Improper positioning
This may look different depending on different factors. This can include your baby’s body being turned away from you, so your baby has to turn their head to the side to latch onto the breast or you have to hunch over to breastfeed your baby.
Their mouth isn’t wide open
You will see that their mouth isn’t open wide. It’ll look shallow if you look at the corners of their mouth.
There’s cheek dimples present
If your baby’s cheeks have very noticeable dimples present while breastfeeding, this is a big sign of a shallow latch.
Their nose is pressed into your breast
During a shallow latch your baby’s nose will be pressed into the breast further than their chin, it should be the other way around.
Their lips are retracted/curled up
If your baby has a shallow latch, their upper and/or bottom lip will look retracted/curled up. You will clearly see your baby trying to hold onto the breast with their lips. They will often have milk blisters on their lips due to having to hold onto the breast with their lips.
Your baby’s tongue doesn’t cover the bottom gum ridge
If your baby’s tongue is retracted during a feed or you feel a choppy sensation, this is a clear sign of a shallow latch.
You’re experiencing pain
Breastfeeding should not be painful. Sensitivity can be expected in the first few days as your nipples get used to the stimulation, but painful nipples are not normal and is a clear sign of a shallow latch.
You will probably hear the advice that sore nipples are normal in the early days or early weeks, this is a myth and if you’re experiencing pain, you need some support.
You hear clicking sounds during a feeding
You may hear clicking sounds often during a feeding. This is due to a shallow latch as your baby is struggling to keep the latch.
You have damaged nipples
Damaged nipples are not normal. If you have nipple damage or raw nipples, you need to be seen by an International Board Certified Lactation Consultant (IBCLC). A shallow latch usually causes damaged nipples.
Your nipples are mis formed when the baby unlatches
Your nipples will usually look like it’s been pinched, or it will look like a lipstick. This shows your baby has a shallow latch and has been feeding on the nipple and not the breast.
Your nipple should come out of your baby’s mouth looking nice and rounded, like it normally does. It may look a bit bigger or longer for a few good seconds, this is normal, but not mis formed nipples.
Your milk supply may be decreasing
If your baby isn’t latching well, they’re probably not removing milk well either. This will eventually cause your milk supply to decrease which will affect your baby’s weight gain.
Your baby may not be gaining weight as expected
As mentioned above, if your baby isn’t latching and removing milk as they should be, their weight gain will not be enough. This is usually one of the first signs of inadequate milk intake, and the latch should always be one of the first things to look at when your baby isn’t gaining weight as expected.
Causes of a shallow latch
Improper positioning
Improper positioning is the most common cause of a shallow latch. Improper positioning is usually a very quick and easy fix.
Latching too soon
In the beginning we’re tired and we’re not as patient as we should be. We often latch our babies onto the breast before they are ready to latch on.
This is why it’s such a good idea to allow your baby to lead you. Make sure your baby opens their mouth very wide before helping your baby latch onto the breast. It will be wide, almost as though they’re yawning.
Oral ties
An oral tie is a restriction of the tongue, lip or buccal. When there’s a restriction in the mouth, your baby’s mouth won’t be able to do what it’s supposed to.
Babies with oral restrictions will usually struggle to open their mouth and extend their tongue over the lower gum ridge. This is why they’ll rather suck on the nipple then the breast, as it’s easier for them or they’re just not able to take in enough breast tissue or move their tongue as they’re supposed to.
A recessed jaw
Most babies are born with a slightly recessed lower jaw. Usually it’s no cause for concern, but some babies may have a severely recessed jaw and won’t be able to breastfeed as they should.
Fast let-down reflex
If you struggle with an oversupply, you’ll probably have a very fast let-down reflex as well. This may often overwhelm babies and cause them to lose their deep latch and slip onto the nipple.
Nipple confusion
Sucking on a pacifier or bottle, especially those with weird teats that encourage a shallow latch may cause your baby to get used to the shallow latch and cause them to latch onto the breast the same way they do with the pacifier or bottle.
How to get a proper latch
Use proper positioning
Start with the very basics, make sure you breastfeed with proper positioning from the very beginning.
There are many different positions, and each position will be different. But in most cases, having them tummy to mummy towards you with their body well aligned, nipple to nose and keeping them nice and close to you is a great beginning.
Correct the latch
Well, this is an obvious one right. Sometimes it’s easy enough to fix a shallow latch with some corrections such as the sandwich hold, waiting for your baby to open wide and unlatching and relatching them as needed.
Try the hamburger/sandwich hold
Your baby’s mouth is still tiny, and they may be struggling to latch onto the breast at first. You can help your baby by shaping your breast before they latch on.
Think of your breast like a big sandwich, compress the breast tissue behind the areola where your baby’s nose and chin are to create that seal. Compressing the tissue allows your baby to use that base to get that deeper latch. Don’t press too hard and don’t compress too close to the nipple.
Practice more skin-to-skin care
Skin contact is so beneficial for both you and your baby. It also helps your milk supply. The best of all is it brings out your baby’s innate reflexes and instincts to help them breastfeed more sufficiently.
If you breastfeed your baby in a laid-back feeding position during skin to skin, your baby will have the ability to latch themselves onto the breast with minimal assistance from you.
See an International Board Certified Lactation Consultant (IBCLC)
If you’re experiencing any difficulty related to breastfeeding, reach out for support from an International Board Certified Lactation Consultant (IBCLC) to help assess and support you and your baby. They will be able to help identify the cause of the shallow latch and they’ll be able to offer you many tips on how to correct it.
Breastfeeding positions
Laid back feeding
Did you know that babies are actually abdominal feeders? This means they feed while lying on their stomach.
Laid back feeding, also known as biological nurturing, is a great breastfeeding position. Not only does it help elicit your baby’s innate reflexes, but it helps with things like a fast let-down reflex to help slow down the flow and it helps babies to latch deeper when they have a recessed jaw.
Cradle hold
This is the classic position most of us picture when we think of breastfeeding. It involves you sitting upright, with your baby positioned on his side, his head and neck laying along your forearm and his body against your stomach, in a tummy-to-mummy position.
Cross-cradle hold
This looks similar to the cradle hold but your arms switch roles, so your baby’s body lies along your opposite forearm. The aim of this breastfeeding position is to support your baby around the neck and shoulders to allow them to tilt their head prior to latch.
This is a great newborn breastfeeding position and is also good for small babies and those with latching difficulties. Because your baby is fully supported on your opposite arm, you have more control over their positioning, and you can use your free hand to shape your breast.
Rugby or football hold
In this position (also known as the underarm or clutch position), you sit with your baby resting along your forearm. Their body tucks alongside your side, with their feet towards the back of the chair, or whatever you’re sitting on.
This is another helpful early nursing position because it supports your baby well, while giving you plenty of control and a good view of their face. Being tucked in closely alongside your body will help your baby feel safe too. Moms who’ve had a c-section, twins, or a premature baby, along with those who have larger breasts, may also find this position helpful.
Side-lying position
This is an ideal position for relaxed nap times and night feeds. Breastfeeding in the side-lying position can also be more comfortable than sitting if you’ve had a caesarean or stitches. You and your baby need to lie on your sides next to one another, belly-to-belly.
Upright or koala hold
In the upright or koala hold, your baby sits straddling your thigh, or on your hip, with their spine and head upright as they feed. You can do this hold with a newborn if you give your baby plenty of support, and it’s also a convenient way to feed an older baby who can sit unaided.
The upright or koala hold is often the most comfortable breastfeeding position for babies who suffer from reflux or ear infections (who often prefer to be upright), and it can also work well with babies who have a tongue-tie or low muscle tone.
Dangle feeding
This breastfeeding position involves your baby lying on their back, while you crouch over on all fours and dangle your nipple in their mouth. Some moms say doing this for short periods helps if they have conditions like mastitis and don’t want their breasts to be squashed or touched; others claim that gravity helps unplug blocked milk ducts, although there’s no scientific evidence to support this yet.
You can also dangle feed while you’re sitting, kneeling up over your baby on a bed or sofa, or almost lying down but propped up on your arms. You may need to use cushions and pillows to support yourself, so you don’t strain your back or shoulders.
How to latch your baby onto the breast
Make sure you have good positioning before latching your baby onto the breast. Never hold your hands on the back of your baby’s head, rather hold their neck, very gently. Give them room to move their head backwards if needed.
Remember that an asymmetrical latch is best for a deep latch. Just remember to keep the nipple to the nose.
Once you’re in a comfortable feeding position, brush your baby’s lips with your nipple to elicit the rooting reflex.
Wait for your baby to open their mouth wide with their tongue at the floor of the mouth. If your baby is crying, their tongue will be at the roof of the mouth, calm them down first before trying to latch them onto the breast.
Once your baby’s mouth is wide open, quickly (but gently) bring your baby to the breast. Do not react too quickly as this will startle your baby.
Aim your nipple towards the roof of your baby’s mouth.
Make sure that your baby’s chin makes contact with the breast first, as this will encourage your baby to take in a large mouthful of breast.
Make sure your baby’s nose is touching or is close to the breast. Anatomy will vary.
Remember, do not place your breast in your baby’s mouth for them, allow your baby to draw the breast into their mouth. Don’t let them slurp the nipple up.
If the latch feels painful, gently break the suction with your pinky or index finger and try again. This may take some practice, but the sooner you and your baby learn how to latch onto the breast properly, the better for the both of you.
Important notes on the latch
Breastfeed should not be painful and your nipples should never be damaged. If you’re in pain, reach out for support. Breastfeeding can be a joyful and beautiful journey with the right support. Don’t wait it out, get support.
If you’re experiencing any nipple soreness or pain while breastfeeding, try to adjust your positioning, or try different breastfeeding positions. Try to get a deeper latch, as deep as possible.
You can contact an International Board Certified Lactation Consultant (IBCLC) at any point in your breastfeeding journey. They can observe a feeding session and help with your baby’s latch to ensure that you have the correct latch, and they can also make sure that your baby is getting enough milk if you’ve been struggling or if you may have been advised to use a nipple shield.
If you’re ever worried about your or baby’s health, seek medical advice from your healthcare provider.
