After birth, your baby may not be able to latch immediately or even for a few days after birth or the first week. You may assume this is a permanent condition and you should give up on breastfeeding before you start. However, a lot of infants have trouble latching or maintaining suction the first few days and sometimes weeks after birth. With patience and situation appropriate treatment, most babies quickly learning to breastfeed.
Dispelling the myths
People often believe their baby is lazy because they nurse slowly, or sleep every time they are placed on the breast. There are two types of situations, babies who nurse poorly and barely suck or infants who appear to be sleeping when placed on the breast even if they were awake before the feeding. There is no such thing as a lazy nurser or lazy baby. Babies are hardwired to survive by breastfeeding, any baby who is not nursing or is not nursing well. Can’t nurse. They are doing the best they can. They are as deeply frustrated as you are. Infants who go to sleep immediately after being latched without sucking are unable to coordinate sucking and swallowing. This may be for a variety of reasons. They are shutting down and conserving calories. They are waiting to feed but are unable to. They appear to be sleeping but when you remove them, they will wake up and cry or fuss.
Reasons why babies are unable to nurse
Prematurity, preterm infants or babies born between 35-37 weeks are often sent home if they weigh over 5lbs but a lot of these babies struggle to coordinate sucking and swallowing.
Labor and delivery drugs can make infants drowsy and can make it difficult for some babies to coordinate latching, sucking and swallowing.
A long labor with an exhausted baby or an infant with a severely molded head or vacuum extracted.
Medical conditions that affect the nervous system such as Down syndrome, may initially make it difficult for a baby's central nervous system to remain alert and coordinated enough to feed in the beginning.
Chronic conditions such as cardiac problems that affect the rate of oxygen exchange as well as making coordinating sucking, swallowing and breathing at the same time difficult.
Acute conditions like newborn jaundice can make newborns very sleepy and difficult to keep alert for a feeding. Jaundice can be very challenging because your baby needs to eat to eliminate jaundice from their system by pooping. If they aren’t eating, they aren’t having dirty diapers either.
Tongue tie, or tongue tie with a severe lip tie as well. Cleft palate or a high palate.
Red flags that are signs you need help
Latching but not sucking.
Baby appears to be sleeping every time they are at the breast, then crying or screaming when taken away.
Doing a searching pattern over the nipple with their mouth open,hands moving rapidly around the nipple/areola then pushing off in frustration when the nipple is right underneath them.
Latching and unlatching frequently then stopping altogether after a few minutes or latching for only a few minutes before completely stopping.
Making loud clicking sounds and frequently losing the latch.
Nurses for 45-60 minutes or longer, and is still hungry. Feeding hourly without being satisfied or has a worried, stressed look all the time.
Body is not soft after a feeding with floppy arms and soft legs. Babies who are hungry are rigid even in their sleep, their arms are held close to the body, hand close to the face with legs flexed inward.
Less than 5-6 dirty diapers and less than 6-8 good soaking wet diapers a day by the end of the first week. Dirty diapers should have more than a quarter size amount of poop, a smear does not count.
A painful, toe curling latch that does not get better during a feeding.
Severe engorgement that is not getting better because too little milk is being removed.
Delayed milk supply in some women from little or no milk being removed.
If you feel something is wrong, follow your instincts. Get help immediately, most metropolitan areas have
private practice IBCLCs, board certified lactation consultants. They are trained lactation specialist who can help you. If you are still in the hospital, ask to see the IBCLC on staff. Most latching and sucking problems are temporary and easily fixed with the helped of a trained lactation consultant. Even with the more challenging situations, breast feeding can be preserved with the help of controlled interventions.