The salient stimulus for latch is the tongue tip touching the breast. 
The stimulus for the best mouth opening is touch of the nipple to the 
philtrum. To get both of these to happen, try having mom bring baby 
closer to her body by having him/her hug the breast (encircle the breast 
with the baby's arms). This brings the chin in, the shoulders into a 
comfortable position, and makes it more likely the baby's tongue will 
contact the breast when the mouth opens.  If the baby has a tight 
tongue, 'exaggerating a mouthful' of breast (Diane Wiessinger's 
brilliant term) can help the tongue contact the breast and the baby 
latch. Rebecca Glover's technique works nicely for exaggerating a 
mouthful. These techniques can all be used during laid back breastfeeding.

Having mom completely/almost supine so gravity pulls the baby down onto 
the breast can help too.

If the tongue seems stuck, especially after frenotomy, or the baby 
repeatedly rolls away from mom, look for torticollis too. The tight 
muscle sometimes makes baby seem stronger, but really they are more 'fixed'.

Catherine Watson Genna BS, IBCLC  NYC  www.cwgenna.com

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