I agree with Heather that the "feel" is more important than what the latch 
actually looks like.  I am trying to find suitable words for explaining how 
a latch *feels*.  At the moment I am asking the mother if she feels a pinch, 
pull, or bite.

On the other hand, one cannot rely just on the "feel" or the shape of the 
nipple after the feed as I was reminded  a couple of weeks ago.  A mother 
was feeding with "no problems" according to the nurses.  Being very busy I 
only paid her a short visit, asked her how it felt, saw the baby come off 
the breast and noted the shape of the nipple and happily went off to assist 
someone else.  The next day, (Day 3) her baby had lost a lot more weight 
than expected, her breasts were full and lumpy, and baby was very sleepy. 
The baby was having changing stools, but that could be misleading as night 
staff sometimes give comps without charting!  (Big sigh!!)This mother had 
large, long, soft nipples.  They were perfectly comfortable during feeding 
and not misshapen afterwards.  Observing baby on the breast, there was no 
swallowing after several minutes of suckling.  The baby was not really 
compressing the areola.  A deeper latch had the baby swallowing very 
quickly, but he tired easily.  As she was going home within the hour, the 
goal was to soften her breasts and fill the baby with EBM and show her how 
to cup feed.  She double pumped for 45 minutes!  She kangarood the baby at 
home, fed him frequently (no cup feeds needed) and the baby gained over 
100mls in 24hours.  A happy ending, but one that nearly slipped through the 
cracks.

Jean Ridler  RN  RM  IBCLC
South Africa   [log in to unmask] 

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