To add to this discussion I have observed something while mothers are
breastfeeding in the hospital.
To help the mothers achieve the asymmetrical latch, the baby needs to
approach the breast at a slight head extension.  What most mothers want to do
is push the baby's head into the breast and this results in either a straight
on latch or worse a flexed latch.
So I work to describe this to the mothers by showing with my face and asking
them to try it themselves by opening their mouth with flexion or slight
extension of the head.  Then I reinforce why they should not be touching the
baby's head but guiding the baby in with it's shoulder, spine and hips.  This
allows the baby to naturally do the slight extension.  If they appear awkward
with this especially in the cradle, I have them use the cross cradle, holding
the baby's neck, shoulder, and spine.  This really works well when they are
in bed.
My theory is that not only does the baby look better from the outside (with
flanged lips, wide open mouth, and chin into the breast) but that the whole
oral cavity has expanded so there is less pinching of the nipple and
discomfort.
What I have also observed with the cradle hold is mom's want to use their
forearm to push the baby into the breast.  So there is this slight rotation
of that muscle which automatically flexes the baby's head.  When I get them
to relax that muscle and only use their hand that has cupped the baby's hip,
they can then bring the baby to the breast with the slight flexion of the
head and asymmetrical latch.
Ann Perry RN IBCLC
Boston, MA


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