How can I re-teach my baby to open her mouth wide when latching on? I feel like I have to wait for her to give a cry to latch her on correctly.

We have learned a lot of exciting things about the reflexive and learned behaviors of newborns and in response in the last decade or two that will help me answer your common question. In response to this new research, even lactation consultants have changed the way we support babies latch. Ten years ago, we may have been quicker to ‘stuff’ the breast into the mouth, even tug on chins to pull mouths more open. We understood that babies needed to open wide, but we didn’t understand the importance of everything leading up to feeding. The way I summarize what we now know about feeding, is that it ‘involves the toes to the nose’ and that the infant is designed to go through a sequence of events that ends in a satisfied feeding.

For instance, if you put your infant skin-to-skin on your belly when you are reclining, your baby will start to pull and push and cycle with her knees/legs and feet in an effort to crawl to the breast. The back muscles contract and the shoulders lift as your baby moves/crawls up to the areola and the hands may push against your chest on either side of the breast as baby lifts her head and bobs to locate the breast. The sensory feedback of your warm skin and the smell of the nipple/milk will cause your baby to salivate, lick, and root. The head comes back and the mouth gapes open, moving onto the breast and taking the areolar tissue and nipple into her mouth. (In the spirit of limiting my word count, I’m even leaving out many little steps that we can identify as newborn feeding reflexes). What we see happening in these feeds is how capable the baby is but also the importance of sequence. If I’m working with an infant who is swaddled, and put her up to mom’s nipple with hands and feet wrapped away and all those steps eliminated, she might latch ok, but she might not. And a simple intervention is to let her use all her natural reflexes to do it herself, from start to finish. We might think it’s helpful when the nurse at the hospital grabs your baby and your breast and pushes the breast into the open mouth, but really, it’s the PROCESS that the baby needs, especially in the early days.

So what I would suggest is to watch her do her baby thing. Let her decide when to latch, rather than feeling like you’ve got to find that right moment and “put” your breast in her mouth, or “pull” her closer to you. When baby is on their tummy (supine) and you are reclining it’s easier for them to be more in charge. I think you would find that you are no longer struggling to find the perfect moment… she’ll be finding it for you. Always go for the earliest feeding cues (lip smacking, tongue motions, hands up at her mouth) and try not to wait for the later cues of crying. Babies lose their ability to organize if they progress to crying. It’s ok- we can’t always get to them so quickly. Just soothe her and let her do her thing. You don’t always need to lie back to feed, but this position allows for the best unfolding of baby’s reflexive behaviors. When we listen to babies, we find we get to be more flexible in many ways. Positioning is how you find yourselves versus “cradle”, “football”, “sidelying”. Your comfort and baby’s behavior will tell you how it’s working.

See this link for more discussion and video demonstrating this ‘laid back’ position:
http://www.biologicalnurturing.com/video/bn3clip.html

In the months ahead, you might hold your baby’s hands while she learns to walk and take steps. If you always held those hands and ‘trained her’ she wouldn’t walk any faster. She has to start with crawling, and pulling herself up, and cruising. Same with feeding. It might take a leap of faith, but so does all things parenting!

I would want you to see a lactation consultant if you were experiencing any discomfort with nursing, had any damage on your nipples and/or if your baby was not gaining well. An infant who cannot achieve a wide gape easily might need a little more support or investigation into underlying causes to ensure successful breastfeeding and ongoing oral development. Some of these situations mean nipples that are sore, and less than optimal transferring of milk. This information does not replace the advice of your lactation consultant or other health care providers. Feel free to call us during regular business hours to just get a little support by phone, or anytime if you need to line up a visit with a lactation consultant or doula.

 

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