February 4, 2021 • 34 mins
Our topic for this week is something that’s absolutely crucial to successful breastfeeding, yet completely mystifying to most new moms.
Today we’re talking about the latch and the hold - two terms that you might not have heard of until just recently, if at all. These actions are the ties that bind momma and baby from day one. So how can something so simple and natural be so complicated at the same time?
When you feed your baby for the first time, two things will effectively make things easy or hard. The first is how your baby latches or holds onto your nipple with his or her mouth while feeding. The second is the hold - the way that you position your baby so feeding is comfortable for both of you. As you probably guessed, feeding your baby is going to become a very consuming part of early motherhood, so nailing the basics is key. That's what we are going to help you do today.
We are thrilled to welcome our guest Leah Tribus to the show. Leah is a Virginia-based IBCLC with Nest Collaborative and a registered nurse. She has worked with moms and babies for 17 years, focusing on lactation for the last eleven.
We look forward to having you join us for today's show mommas!
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Amanda Gorman (00:00):
[Intro] Breastfeeding Unplugged.
Welcome. Welcome. Welcome mamasand mamas to be. A podcast
dedicated to helping momsnavigate their way through the
tricky world of breastfeeding.
Breastfeeding Unplugged.
(00:22):
Breastfeeding Feeding.
Welcome, mamas and mamas-to-be.
And thank you for joining me foranother episode of Breastfeeding
Unplugged. I am your host AmandaGorman of Nest Collaborative.
And our topic for this week issomething that's absolutely
crucial to successfulbreastfeeding, yet completely
mystifying to most new moms.
(00:45):
Today we are talking about thelatch and the hold. Two terms
that you might not have heardof, until just recently, if at
all. These actions are the tiesthat bind mama and baby from day
one. So how can something sosimple and natural, be so
complicated at the same time?
When you feed your baby for thefirst time, two things will
(01:05):
effectively make things easy ordifficult. The first is how your
baby latches, or how they holdon to your nipple with his or
her mouth while they're feeding.
The second is the hold, the waythat you position your baby so
feeding is comfortable for bothof you. As you've probably
(01:25):
guessed, feeding baby is goingto become a very consuming part
of early motherhood. So nailingthese basics is key. That's what
we're going to help with today.
I'm absolutely thrilled towelcome our guest, Leah Tribus,
to the show to tell us all aboutthe latch and the hold. Leah is
an IBCLC and a registered nurseand has worked with moms and
(01:48):
babies for 17 years, focusing onlactation for the last 11. Over
the course of her career, Leahhas enjoyed various roles as a
mother-baby nurse, a nurserynurse and childbirth and
breastfeeding educator. Keepingher busy in Virginia are three
lovely little girls, in additionto her venture For All Momkind,
(02:09):
which provides education andsupport to moms who are being
treated for addiction. Leah,welcome to the show. It's so
wonderful to have you with us.
Leah Tribus (02:17):
Thank you so much for having me. I'm excited to be
here.
Amanda Gorman (02:19):
Before we start talking about this holy grail of
breastfeeding success. I'd loveto hear from you about your
experiences with moms duringtheir very first moments of
breastfeeding. So what is itlike to have that new baby in
your arms feeling for the firsttime?
Leah Tribus (02:35):
So for a lot of moms, it's it's overwhelming
with emotions. It's verysurreal. Moms are elated and
overwhelmed, excited, maybe alittle scared. I think it's all
of their imagination coming tofruition at one moment getting
to meet their baby for the firsttime. So I would say hormones
are surging, emotions aresurging for sure.
Amanda Gorman (02:56):
Sounds- sounds familiar. If I think way back.
All right, well, let me jump inright away with the latch. I
mean, is it really thatimportant?
Leah Tribus (03:08):
So the latch is pretty much the foundation for
success in breastfeeding. Andit's how we get milk- how your
baby gets milk. So a painfullatch or a bad latch isn't just
unfortunate for the mother. It'slike kind of sucking through a
coffee straw to get fed. So alot of effort for just a small
(03:28):
amount of food. And a good deeplatch and a comfortable latch,
get the most milk to your babyefficiently. So that's why this
is sort of the cornerstone ofbreastfeeding.
Amanda Gorman (03:40):
All right, well, like you said, you know, there
is and can be some pain and Ithink a lot of moms that we talk
to are afraid of pain. So can webreak that down a little bit? Is
it supposed to be painful?
Leah Tribus (03:51):
That's a great question. Usually there's
somebody in your life a grandma,a girlfriend, who tells you to
expect pain, or breakdownmeaning cracks, nipples,
bleeding, blistering, bruising.
This is never a normal part ofbreastfeeding. So where pain is
concerned, it should never besomething that has to be endured
for the breastfeedingrelationship. And if a mom is in
(04:13):
a lot of pain, it's always agood idea to have someone
checking the latch, making surethat we can problem solve why
that's happening.
Amanda Gorman (04:24):
Okay, well, that's relieving. In terms of
kind of preparing to breastfeed,should moms be like toughening
up their nipples prenatally atall?
Leah Tribus (04:35):
So that's another sort of misnomer. Our nipples
will change. If you are pregnantnow, you'll know that your
nipples and your areolas havechanged, likely, and they will
change with breastfeeding. Butwhat shouldn't happen is any
sort of callous thing ortoughening of the nipple, that
again would be coming fromdamage. So there's no need to
(04:56):
prep your breast or nipples inany way for breast feeding. Our
bodies were made to do it andduring pregnancy, our body gets
ready to do it.
Amanda Gorman (05:05):
Okay. So one thing that's not obvious is- or
to most moms isn't very obviousis exactly which part of the
nipple or areola should be goinginto baby's mouth. Like, is it
just the tip? Is it the wholeshebang? What should they be
looking for to identify whetherbabies latched in the right
(05:26):
position?
Leah Tribus (05:28):
So that's a wonderful question. I've been
doing this a really long time.
So I've seen lots of breasts,different shapes, areola sizes,
nipples, all of that. And ifthat's not something you do for
a living, you wouldn't know. Butthey do come in all different
sizes and shapes. So there was aprevious teaching that would
tell moms, you need to get yourentire areola in baby's mouth.
(05:50):
Well, for a mom with a quartersize areola, that's doable. But
a mom with a much larger areolasand dollar size, it would be a
lot harder. So that is notwhat's important, the areola.
What's more important is thatthe baby has enough of the
breast tissue in the mouth, forthat effective transfer of milk
and comfort to mama. So a babywho sucks on the tip of the
(06:14):
nipple will hurt mom, and won'tbe massaging the milk duck, and
therefore won't be getting themaximum amount of milk. So
remember, a shallow latch is abad- it's bad for all parties.
So it's not something we everwant. And so for me, I kind of
tell moms touch her nipple rightunder the baby's nose. This will
get infant to lift the chin up,extending the neck, sort of like
(06:37):
they're sniffing. And thisallows what we call an
asymmetrical latch. And thatasymmetrical latch will aim the
nipple towards the roof of themouth where the baby can respond
and suck. And then it willensure that the nipple will
reach back to the soft palatewhere the latch becomes really
deep and comfortable for them.
Amanda Gorman (06:57):
Okay, so what should we be looking for on baby
in terms of signs that she or heis latched properly?
Leah Tribus (07:09):
So if you kind of think about your geometry class,
which I did not excel in, butyou want your baby's mouth
angled at about 120 degrees orbigger, and if math is not your
thing, you want to think aboutyour baby's mouth being about as
wide open as it would be whenthe baby is yawning. So it's
(07:29):
pretty wide open. Both thatupper lip and a lower lip should
sort of flange out, not becurled in, and the lower lip
will cover a little bit more ofthe areola than the top lip. The
top lip's really resting on topand kind of as a placeholder.
Amanda Gorman (07:46):
Okay, well, that's really helpful. Are there
any telltale signs that momsshould be looking out for with
regards to a poor latch or animproper latch?
Leah Tribus (07:57):
Yes, absolutely. So we already said that pain is
bad. So we already know that'sbad. But if you're actually
visualizing looking at the baby,if we see the actual nipples,
they're not the areola whenwe're talking about anatomy. But
the actual nipple in the cornerof the baby's mouth or the base
of the nipple is actuallyshowing because the baby's so
(08:17):
narrow, and if the baby's mouthor lips look pur- pursed, kind
of like a kiss, that's typicallygoing to be a poor latch or a
shallow latch. And it alsousually results in sort of like
loud smacking sounds, that sortof indicate to us that baby
doesn't have a good feel aroundmom's breast.
Amanda Gorman (08:38):
Okay, so I mean, if if mom is suspecting that the
latch might be off, how longshould she try before reaching
out to get help?
Leah Tribus (08:49):
So it's always good to feel like you have a basis
when you start. Obviously, youdon't want to go into this
completely blind. And maybethat's part of the reason why
you're listening to thispodcast. But it's helpful to
kind of know what is normal andwhat is not. So now that you
understand that, you know,latching shouldn't be painful.
You should never suffer througha feeding because one bad latch
(09:12):
one bad feeding could causedamage to the nipple, and then
we're having to do a lot of workto get mom comfortable again. So
it's always a good idea,especially if you birth in a
hospital or even a birthingcenter to have someone take a
look. If you are unsure if thelatch is correct, if you're
having some pain, ask yournurse, ask the lactation
(09:32):
consultant to come say, hey, howdoes this look? Does this look
correct? Because it's botheringme a little bit so that we can
intervene sooner rather thanlater.
Amanda Gorman (09:41):
Okay, now, I know from my own personal experience,
I actually didn't have problemsin the hospital but they kind of
started once I got home. So whatresources are out there for moms
who don't start to get into thetrouble zone until they are out
of the hospital?
Leah Tribus (09:58):
So I think this is actually a really common
problems. So if anyone'slistening that has a baby and
has gone through this, they'veprobably experienced a similar
issue. There tends to be in thatfirst week of life, a lot of
critical- critical changes whatwith the milk coming in, the
breast getting engorged, andthese sort of things that make
little speed bumps to ourbreastfeeding journey. So I find
(10:19):
that without support, so withouta phone call, a visit to someone
who knows what they're doing,parents are really blindly
trying to navigate, which isreally hard. And it's completely
okay and expected to ask forhelp.
So, I find that there is acouple good sources out there.
One is if it 2am and you'relooking for some solid
(10:42):
information I really, reallylike kellymom.com. It's very
reputable information written bypediatricians, lactation
consultants that haveexperienced. And it's a go to
for me sometimes when I'm notsure of something. So that's a
great place to do some researchrather than Google. Secondly,
most hospitals do offer someoutpatient, at least telephone
(11:04):
support. I know at one of thehospitals that I work, we do
offer that. So at the very levelthat nurse can or lactation
consultant can triage for youand say, hey, I think this
warrants you having a telehealthvisit, or if it's something more
serious, having an actualoutpatient visit. Some
pediatricians office will havelactation consultants on staff
(11:26):
and some pediatricians areactually certified themselves.
But what you have to kind of askyourself is is this person doing
lactation all the time, or justsome of the time? So it's always
good to seek out professionalsthat do this pretty much all the
time, because they're seeing thesame issues and can help you
with them. So I love the idea ofreaching out for maybe some
(11:47):
triage information from thehospital if that's available.
And then going straight totelehealth if it's available,
like with Nest Collaborative,and then they'll let you know.
Do you need to see a person inperson to get a weight check or
any other thing that your babymight need?
Amanda Gorman (12:05):
Okay, that I love it. That's great. And that's
really good for moms to knowwhat their options are once
they're once they're home. Sofor second times moms, is it- is
it the same necessarily from onebaby to another for moms who
were successful with one? Arethey you know, is it pretty much
a sure shot for baby number two,or vice versa? If mom struggles
the first time should she expectthe same issues with her next
(12:29):
baby?
Leah Tribus (12:30):
So that's also a great question because every
baby is different. I explainthis a lot to moms when they get
varied information from onepregnancy to another, from one
baby to another. And I remindthem that we're not robots. So
one solution for one baby mightnot be the solution that works
for another. One problem mightnot be the same exact problem.
(12:51):
So we have to look at each babypretty individually. Now if a
mom had an issue, something withher supply, we are going to
watch her really closely to seeis that going to occur a second
time. But with babies,typically, if it was a mouth
anatomy issue, or just mom notunderstanding that she needs to
ask for help, we can certainlyhelp her earlier on. I have
(13:16):
situations all the time whereparents have had a rough
experience with the first babyknow what to do and what to ask
the second time, and thereforehave better success and are
calmer the second time around.
So it's not always that case, itcan go the opposite. Some of
them have wonderful luck withtheir first baby, my firstborn
was an absolute dream when itcame to breastfeeding. And my
second was a challenge. So youcertainly can have the opposite
(13:39):
happen. And that's where, again,reaching out for support is so
important. Just because you're asecond time mom or third time
mom, doesn't mean that you'renot allowed to ask questions.
Amanda Gorman (13:52):
No, absolutely not. super helpful. Thank you so
much. One more question I havehere is can a baby latch
differently on one boob than shedoes on the other side?
Leah Tribus (14:04):
I mean, again, typically we're not- we are
breast shape, size, nipplesshape, size, might not be
identical. There may be somedifferences also with your
comfort level. So if you'reright handed, you may be more
comfortable in certain holds onthe right breast than you are in
the left breast. And somebabies, some babies can actually
scent that- sense that. So Ithink it's really helpful to
(14:27):
recognize that breast preferenceis what moms will say, my baby
prefers the right, you know, ormy baby prefers the left, is
often something a combination ofmom's anatomy, maybe one nipple
is larger than the othertherefore easier for baby to
take. It could be the amount ofcolostrum coming out of one side
versus the other. And then ontop of that we layer in your
(14:49):
comfort level. Maybe you have anIP in one of your hands and it
makes it a little bit difficult.
So certainly babies can preferor one side can feel easier, but
that does usually level off withgood support, problem solving,
and then once the milk comes in,I do find that babies are a
little less picky, because thevolume is there, and they're
just excited to be fed.
Amanda Gorman (15:11):
Of course, aren't we all? All right. Wow, well
you've really given us a lot tothink about already. I would
like to pivot a little and talkabout the best positions to hold
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Hey, everyone, we are back withLeah Tribus, who has really
given us a fantastic one o oneon what to expect when a baby
latches on the breast for thefirst time. But now I'd like to
change gears a bit and chatabout the hold. And how moms can
(16:40):
support their babies in a waythat's comfortable both for
their little one and themselves.
So Leah, let's start talkingabout the most basic aspect of
holding the baby whilebreastfeeding. Why is
positioning so important for it?
Leah Tribus (16:55):
So it's interesting because I do feel that we focus
always on latching. And it is soimportant. But it's important to
know that without goodpositioning, a good latch can't
be achieved. So they really gohand in hand, it's really you
must have one to have the other.
So I see a lot of moms who haveseen pictures of mom holding
their baby in the crook of theirarm like that traditional cradle
(17:19):
hold. And that's what theirdefault is they kind of go to
that position thinking that'sthe way we all breastfeed. And
it's actually much more thanthat. So I find that, you know,
to get that comfortable latchwe've been talking about, we
really have to focus on bodymechanics. You know, as adults,
we're told how to sit at ourdesk and where our monitor
height should be. And we have toremember that body mechanics for
(17:40):
our newborns, is just asimportant. Babies can't swallow
well or maintain suction whenthey have poor body positioning.
Amanda Gorman (17:51):
Well, that makes total sense as I straighten up
in my chair here. So a lot ofmoms are afraid that their baby
can't breathe while they'refeeding. Is that true? Or, how
can they be assured that baby'sbreathing fine, when it might
not look as though that's thecase?
Leah Tribus (18:08):
Yeah, I mean, that's, that's valid. Some moms
with larger breasts really worryabout that, especially if their
breasts are what we callpillowy, nice and soft, like a
pillow. But again, with properbody mechanics, kind of getting
that asymmetrical latch likewe've chatted about. It will
help facilitate a position inwhere baby's nose isn't buried
(18:28):
in mama's breasts. Also, it'skind of interesting to note that
baby's noses are actually a bitflat at first. And this is
specifically so that- becausethey are meant to kind of press
against mom's breast. And thislets them get a deep latch and
they still can breathe. So mytypical rule of thumb is if you
can semi visualize one nostrilfrom the side, we're pretty
(18:51):
good. And I usually showexamples of you know how you can
breathe. If you put your hand upto your nose, you actually can
still breathe okay. So I'll haveparents kind of try that. So
they can be like, oh, yeah,okay, that baby can breathe.
Amanda Gorman (19:06):
Okay, well, that's easy. What do you think
are really the best positionsfor newborns who are learning to
nurse?
Leah Tribus (19:14):
So I think things that provide good body mechanics
for both mom and baby are thebest. And so my two favorite
holds for newborns are going tobe the cross fetal position and
the football hold. Before I kindof explain what those are, I do
like to explain just kind of thebasics of a hold. So in any
breastfeeding hold, the baby'sbody should be aligned. And what
(19:37):
I mean by that is the baby'sear, shoulder, and the hip
should all be in a line. Thehead should kind of be straight
on and shouldn't be twisting toone side or the other. And
that's important as like thevery basis for effective and
comfortable feeding. And wetalked about before you lining
your nose up with baby's nippleand by aligning your nipple up
(19:58):
with baby's nose, touching thebaby right under the nose, which
will allow baby to lift likethey're sniffing and get that
asymmetrical latch. And wheremom's supporting hand will be is
between baby's shoulder bladeson the back, and the nape of
your baby's neck will restbetween mom's fingers and thumb.
This hold really allowsflexibility of movement for baby
(20:22):
because babies don't rigidlyattach to the breath. And it
allows mom a lot of control overbaby's head and neck versus the
traditional cradle hold, forexample. So both the football
hold and the cross cradle kindof achieve these things, which
is why they're my favorite.
They're also my favorite givenbaby sizes. So a three months
old, you can throw in the crookof your arm, they know how to
(20:42):
self attach, and the cradle ho-hold works just fine. But for
those new tiny babies that needso much assistance to get to the
breast, we really want to makesure that we have full control
if we can. So cross cradle, momshould be slightly reclined,
this always helps- gravity isgoing to help hold baby to mom's
breast. So she'll bring her babytummy- so baby's tummy to mom's
(21:04):
tummy. And when mom looks down,she'll see that good body
alignment we talked about. Andin this way, the baby can push
that chin into the breast, theneck will be extended, and the
nose and forehead will beslightly rocked or angled off
the breast, and the baby laysacross mom's belly. And that's
in that semi reclined position.
(21:27):
And it really once we kind oftweak that and get that right.
It's a beautiful, wonderful,comfortable position. Some
momma's have more successfulfootball, especially if they've
had a cesarean and they'renervous about having the baby
lay on their stomach. So in thefootball hold, the baby's sort
of wrapped around your sideturned into you again. But it's
more like baby's tummy onto yourribs or your side. And you kind
(21:50):
of have them tucked in likethose quarterback people, you
know, run around with thefootball, which is where it got
its name. So but really whatyou're doing is you're- your
supporting arm is holding thebaby close to the body. And the
other hand is going to sandwichyour breast in a V-shape. In any
hold we use when we compress thebreast like a sandwich, it
allows better control of thebreast, and that deeper latch we
(22:13):
keep talking about.
Amanda Gorman (22:15):
So helpful. Thank you. Will- well you just spoke a
little bit about- so it seemsthat positions will change a
little bit as the baby getsolder. Is that something that's
more of a preference for baby orjust natural as the baby grows
and develops.
Leah Tribus (22:33):
Yeah, I think it's really a natural progression. I
think as moms become much morecomfortable with what that latch
is supposed to feel like. Sowhen they start to learn, the
difference between this isreally wrong, or yay, this is
right, then they can start kindof modifying their positioning,
because they know if they make aminor adjustment and it hurts,
(22:54):
oops, I got to change back tothat other hold. So it really
allows moms once they'recomfortable to experiment a
little bit and figure out- Ikind of say there's no wrong
when it comes to latching unlessit hurts or positioning. So moms
are allowed to try a variety ofdifferent things. If it's
working for them, I say go forit. And I find that again, once
you're at home in yourenvironment where you can kind
(23:17):
of freely have no shirt on,snuggle your baby a lot, and
nurse in a variety of places,you will start to develop
preferences. And it's based onboth of you. So I think once
baby can self attach muchbetter. And once you get that
comfortable latch, you reallycan try a bunch of things that
work work very effectively. Butfor that newborn period those
(23:38):
are my favorite.
Amanda Gorman (23:39):
Gotcha. So what about twins? When you're trying
to hold twins do you do one babyat a time? Two babies at once?
What does that look like?
Leah Tribus (23:49):
So that is- that is something of course that twin
moms want to know a lot. Andwhat I find I always try to do
with my clients and patients isprovide for them a achievable
goal. And I think while tandemfeeding is beautiful and
wonderful. It's like we talkedabout with these little bit more
(24:10):
advanced positions that we getinto when we're comfortable. It
sometimes can be tricky, not foreverybody. But in the first
early days, it can be tricky fornew mamas. And I don't ever want
a mom to feel like they're setup for failure. So we always
will practice I tell them to tryto do a little bit of
practicing. But I also allowthem that space to know that if
(24:31):
they need to feed one baby andthen feed the second baby,
that's also totally okay. Soit's really mom's preference.
Tandem feeding can be wonderfuland very time saving when we get
that down when we kind ofachieve that. But understanding
that twins can have a lot ofdifferent nuances, that they're
a little bit early, and thingslike that. That can make a
(24:53):
difference in how often tandemfeeding is successful and that
newborn period. Once we do wantto try it though, the positions
that we talked about work reallywell. Usually you need a much
larger surface area. So somepillows, there's a couple
breastfeeding pillows that aremeant for twins, they give you
more real estate to work with.
And so usually if you havesomeone nearby to help, you can
(25:16):
do the football hold attachingone baby. And then there's the-
your helper can help bring thesecond baby under your other
arm. So you can do football onboth sides. Once they're there,
you do great. You can also doone side football and one side
prop cradle. That also seems towork really well for some mums.
But you definitely need thoselike extra pillows for support.
(25:38):
And sometimes you need an extrahand or two in there to
initially get babies latched.
This also works the same, ifyou're breastfeeding a toddler
and a newborn. You can dovarious positions, depending on
where you're sitting, where yourtoddler is kind of on one side
with the body away from you. Andthen you're you can focus more
(25:59):
on the newborn, because yourtoddler knows how to attach. So
tandem feeding for an olderchild and a baby can be a little
bit simpler.
Amanda Gorman (26:08):
Gotcha. Yeah, we do don't- we know those toddlers
like to move around a lot too.
Leah Tribus (26:13):
Right.
Amanda Gorman (26:14):
So what would you say are some of the kind of
common positioning mistakes thatmoms might be more apt to make?
Leah Tribus (26:23):
So I touched on it a little bit. But that
traditional cradle hole that weso often see pictured, I
actually find I see it a lotwith second time moms. So I have
a second time mom, she comesinto the office telling me, you
know, I feel like I should knowwhat I'm doing. But this latch
that my baby's doing is painful,please help me. And what it ends
(26:45):
up being is that they have thebaby not aligned properly. So
either the baby sort of sittingin their lap with the neck
twisted towards their nipple,and baby's yanking on the nipple
kind of not square on but sortof pulling, or the mom has a
baby in the crook of her arm.
And that cradle hold with thebaby a little bit too far to
mom's armpit. And when thebaby's not in front of the
(27:05):
breast, so I touched on keepingthe nose across from mom's
nipple, when that's nothappening, if the baby brings
the chin to the chest. Soinstead of that sniffing
position, it's kind of theopposite the chin is headed
towards the chest, the nipplegets mashed on the hard palate,
which is not comfortable. And italso results in that more
(27:27):
shallow draw and transfer ofmilk as well. Um so that's
really the most common issue Isee is that chin kind of resting
against the chest, we can'tslide a finger between the chin
and chest, baby's nose is buriedin the breast. And moms are
complaining of this pinching orclamping or biting. And that's
really, really common again,because a lot of times in the
(27:50):
delivery room, you're kind oflike left on your own to figure
out this breastfeeding thing thefirst time. And when that
happens, you're using only whatyou've seen. And you're kind of
assuming what the positioningis. And so that traditional
cradle hold with that chinagainst the chest would be like
the most common issue that I seethat causes discomfort.
Amanda Gorman (28:14):
That makes total sense. Also another great reason
why it's so helpful to have alittle bit of prenatal education
going in, because some of thisstuff you can discuss and know
ahead of time.
Leah Tribus (28:24):
I'm sorry, can you repeat that?
Amanda Gorman (28:25):
I said, it's why it's so good to have some
prenatal education before babyarrives on breastfeeding.
Leah Tribus (28:31):
It's amazing. And I find that moms that are prepped
and come in prepped have alreadystarted that football hold, have
already started the crosscradle, they have minor tweaking
questions. It's really such awonderful resource because your
brain is much clearer duringthat pre baby stage than right
after the baby's born when it'sreally hard to absorb all the
information.
Amanda Gorman (28:51):
Mm hmm. A lot going on. Alright, so baby's
hands, they're always getting inthe way. Do you have any
suggestions for how mom can kindof get them a little bit under
control so she can really workon that latch?
Leah Tribus (29:04):
Yeah, so I've been doing this like, you intro'd me
for a long time. And I havenever done a lot of research
about baby's hands. Just wasn'tsomething that was on my radar.
I knew they got in the way andthat sometimes they were a
barrier, that baby was suckingon the hand instead of kind of
rooting towards mom's breast.
And recently, I found thisarticle by the San Diego
Breastfeeding Center. And it hadthis great information about how
(29:28):
the baby's hands have thispurpose. So they seem like a
nuisance, but they really havethis purpose. Newborns have
really poor eyesight, which allof us probably learn a little
bit in our prenatal research. Sothey have to use all of their
senses to find our breast. Sothey will use their hands to
(29:48):
sort of ground themselves. Ifyou were falling forward, you
would want your hands out. Youwouldn't want your hands behind
your back. So babies use theirhands to ground them. They also
use the hands to search aroundand help them find the breast
and the nipples. So, when babiesget stuck in sort of this like
mood where their hands are upreally tight against their body,
(30:11):
which can happen when they're alittle over hungry, and they're
really gnawing at their hands,if you move your- if you kind of
move your nipple or your breastover to baby's cheek and face,
sometimes that will result inthem moving that hand out of the
way. And then therefore,subsequently latching at the
(30:31):
breath. Um the other thing youcan do is gently let baby grip a
finger. So sometimes I do thiswhen I'm in a consult, and I
gently move the hand up abovethe breast. So I'll usually have
one hand under the breast, andone hand over the breast, kind
of like the baby's hugging thebreast. And that keeps them
really grounded and keep theirmouth and area we need it to be
(30:51):
which is right at the nipple.
Amanda Gorman (30:56):
Helpful, very interesting, because you think
sometimes you just think oh,swaddle that baby, and get those
arms out of the way. But itsounds like that they need them.
Leah Tribus (31:05):
Yeah, and I mean, some moms will swaddle and will
actually like forcibly hold thearms down thinking like that's
going to help the baby. Butoften, this can disorient them.
So, you know, again, imaginehaving your hands tied behind
your back and trying to eat offa plate, it would be pretty
tough.
Amanda Gorman (31:21):
Good point. Okay, so lastly, is there any gear or
accessories that might help babylatch better or help mom hold
better. Anything good for momsto have before baby's arrival?
Leah Tribus (31:35):
So that's a wonderful question. There are a
lot of tools out there. And Ifeel like in the last 10 years,
more and more things have beendeveloped and become available
to mom. I'm always trying tostay up, my youngest is 10 now,
so I'm always trying to ask myfriends that are having babies,
what's the new, what's thescoop? What are the new brand
names and what's going on. Butone thing that has been around
(31:56):
for a long time, and I find veryhelpful is the Breast Friends
Pillow, they have the regularversion and they have a twin
version. And what I like aboutthis pillow is you adjust it to
fit your specific waist. As youlose your baby belly, it will
get- you can tighten it and itwill get smaller. And it
provides really firm support.
And I think that's reallyimportant in the early stages.
(32:19):
Because really soft, squishysupport can be much harder to
kind of manipulate to work foryou. So I don't think you need a
pillow. I think you needpillows, I don't necessarily
think you need a breastfeedingpillow. But if we're getting
one, if you're putting one onyour registry, that's the one I
like. And other than thatregular pillows work great.
(32:43):
Sometimes a regular pillow slidunderneath the Breast Friend
Pillow is really helpful untilthe baby's bigger. But having
some support under your arm,across your your waist is really
helpful because what we don'twant to do is round our back and
try to stretch our breast downto our baby. We've seen images
of bottles our whole lives. Andsometimes I see moms treating
(33:06):
their breasts like they're abottle like they're gonna come
off their body and go down intothe baby's mouth. So to fully
kind of take advantage of all ofbaby's reflexes and innate
features that make them be ableto breastfeed from an early
hours of life, is to bring babyup to you, not yourself down to
the baby. So whatever tools youneed to help facilitate that. I
(33:27):
say go for it and every mom isdifferent. But definitely know
that you're going to need somelike firm back support in your
bed if you're going to try tobreastfeed in bed and then
having something under the babyor under your arms to support
the weight of the baby is alsovery helpful.
Amanda Gorman (33:44):
Awesome, Leah thanks so much. I feel like you
really nailed everything andexplained everything so well.
It's been amazing and I reallythank you for joining us today.
If I may-
Leah Tribus (33:54):
It was fun thanks for having me-
Amanda Gorman (33:55):
Yeah, no, no if our listeners do want to get in
touch with you what is the bestway to do that?
Leah Tribus (34:01):
You can use my email address which is
Leahtribus "Leah Tribus" lc (asin lactation consultant)
@gmail.com.
Amanda Gorman (34:12):
Awesome. Well, excellent. Thank you so much.
Leah Tribus (34:14):
Thank you.
Amanda Gorman (34:15):
To our mamas and mamas-to-be that is all of
today's show for you today. Asyou know by now, we are all
about tackling yourneed-to-knows so please don't be
shy. Reach out to us atwww.breastfeedingunplugged.com
or send us a message on Facebookor Instagram
@breastfeedingunplugged to askyour burning question. Until
(34:36):
next week. It's me Amanda sayingthanks for being with us today.
Boo bye.
[Outro] Breastfeeding Unplugged.
Breastfeeding Unplugged.
[Intro] Breastfeeding Unplugged.
Welcome. Welcome. Welcome mamasand mamas to be. A podcast
dedicated to helping momsnavigate their way through the
tricky world of breastfeeding.
Breastfeeding Unplugged.
(00:22):
Breastfeeding Feeding.
Welcome, mamas and mamas-to-be.
And thank you for joining me foranother episode of Breastfeeding
Unplugged. I am your host AmandaGorman of Nest Collaborative.
And our topic for this week issomething that's absolutely
crucial to successfulbreastfeeding, yet completely
mystifying to most new moms.
(00:45):
Today we are talking about thelatch and the hold. Two terms
that you might not have heardof, until just recently, if at
all. These actions are the tiesthat bind mama and baby from day
one. So how can something sosimple and natural, be so
complicated at the same time?
When you feed your baby for thefirst time, two things will
(01:05):
effectively make things easy ordifficult. The first is how your
baby latches, or how they holdon to your nipple with his or
her mouth while they're feeding.
The second is the hold, the waythat you position your baby so
feeding is comfortable for bothof you. As you've probably
(01:25):
guessed, feeding baby is goingto become a very consuming part
of early motherhood. So nailingthese basics is key. That's what
we're going to help with today.
I'm absolutely thrilled towelcome our guest, Leah Tribus,
to the show to tell us all aboutthe latch and the hold. Leah is
an IBCLC and a registered nurseand has worked with moms and
(01:48):
babies for 17 years, focusing onlactation for the last 11. Over
the course of her career, Leahhas enjoyed various roles as a
mother-baby nurse, a nurserynurse and childbirth and
breastfeeding educator. Keepingher busy in Virginia are three
lovely little girls, in additionto her venture For All Momkind,
(02:09):
which provides education andsupport to moms who are being
treated for addiction. Leah,welcome to the show. It's so
wonderful to have you with us.
Leah Tribus (02:17):
Thank you so much for having me. I'm excited to be
here.
Amanda Gorman (02:19):
Before we start talking about this holy grail of
breastfeeding success. I'd loveto hear from you about your
experiences with moms duringtheir very first moments of
breastfeeding. So what is itlike to have that new baby in
your arms feeling for the firsttime?
Leah Tribus (02:35):
So for a lot of moms, it's it's overwhelming
with emotions. It's verysurreal. Moms are elated and
overwhelmed, excited, maybe alittle scared. I think it's all
of their imagination coming tofruition at one moment getting
to meet their baby for the firsttime. So I would say hormones
are surging, emotions aresurging for sure.
Amanda Gorman (02:56):
Sounds- sounds familiar. If I think way back.
All right, well, let me jump inright away with the latch. I
mean, is it really thatimportant?
Leah Tribus (03:08):
So the latch is pretty much the foundation for
success in breastfeeding. Andit's how we get milk- how your
baby gets milk. So a painfullatch or a bad latch isn't just
unfortunate for the mother. It'slike kind of sucking through a
coffee straw to get fed. So alot of effort for just a small
(03:28):
amount of food. And a good deeplatch and a comfortable latch,
get the most milk to your babyefficiently. So that's why this
is sort of the cornerstone ofbreastfeeding.
Amanda Gorman (03:40):
All right, well, like you said, you know, there
is and can be some pain and Ithink a lot of moms that we talk
to are afraid of pain. So can webreak that down a little bit? Is
it supposed to be painful?
Leah Tribus (03:51):
That's a great question. Usually there's
somebody in your life a grandma,a girlfriend, who tells you to
expect pain, or breakdownmeaning cracks, nipples,
bleeding, blistering, bruising.
This is never a normal part ofbreastfeeding. So where pain is
concerned, it should never besomething that has to be endured
for the breastfeedingrelationship. And if a mom is in
(04:13):
a lot of pain, it's always agood idea to have someone
checking the latch, making surethat we can problem solve why
that's happening.
Amanda Gorman (04:24):
Okay, well, that's relieving. In terms of
kind of preparing to breastfeed,should moms be like toughening
up their nipples prenatally atall?
Leah Tribus (04:35):
So that's another sort of misnomer. Our nipples
will change. If you are pregnantnow, you'll know that your
nipples and your areolas havechanged, likely, and they will
change with breastfeeding. Butwhat shouldn't happen is any
sort of callous thing ortoughening of the nipple, that
again would be coming fromdamage. So there's no need to
(04:56):
prep your breast or nipples inany way for breast feeding. Our
bodies were made to do it andduring pregnancy, our body gets
ready to do it.
Amanda Gorman (05:05):
Okay. So one thing that's not obvious is- or
to most moms isn't very obviousis exactly which part of the
nipple or areola should be goinginto baby's mouth. Like, is it
just the tip? Is it the wholeshebang? What should they be
looking for to identify whetherbabies latched in the right
(05:26):
position?
Leah Tribus (05:28):
So that's a wonderful question. I've been
doing this a really long time.
So I've seen lots of breasts,different shapes, areola sizes,
nipples, all of that. And ifthat's not something you do for
a living, you wouldn't know. Butthey do come in all different
sizes and shapes. So there was aprevious teaching that would
tell moms, you need to get yourentire areola in baby's mouth.
(05:50):
Well, for a mom with a quartersize areola, that's doable. But
a mom with a much larger areolasand dollar size, it would be a
lot harder. So that is notwhat's important, the areola.
What's more important is thatthe baby has enough of the
breast tissue in the mouth, forthat effective transfer of milk
and comfort to mama. So a babywho sucks on the tip of the
(06:14):
nipple will hurt mom, and won'tbe massaging the milk duck, and
therefore won't be getting themaximum amount of milk. So
remember, a shallow latch is abad- it's bad for all parties.
So it's not something we everwant. And so for me, I kind of
tell moms touch her nipple rightunder the baby's nose. This will
get infant to lift the chin up,extending the neck, sort of like
(06:37):
they're sniffing. And thisallows what we call an
asymmetrical latch. And thatasymmetrical latch will aim the
nipple towards the roof of themouth where the baby can respond
and suck. And then it willensure that the nipple will
reach back to the soft palatewhere the latch becomes really
deep and comfortable for them.
Amanda Gorman (06:57):
Okay, so what should we be looking for on baby
in terms of signs that she or heis latched properly?
Leah Tribus (07:09):
So if you kind of think about your geometry class,
which I did not excel in, butyou want your baby's mouth
angled at about 120 degrees orbigger, and if math is not your
thing, you want to think aboutyour baby's mouth being about as
wide open as it would be whenthe baby is yawning. So it's
(07:29):
pretty wide open. Both thatupper lip and a lower lip should
sort of flange out, not becurled in, and the lower lip
will cover a little bit more ofthe areola than the top lip. The
top lip's really resting on topand kind of as a placeholder.
Amanda Gorman (07:46):
Okay, well, that's really helpful. Are there
any telltale signs that momsshould be looking out for with
regards to a poor latch or animproper latch?
Leah Tribus (07:57):
Yes, absolutely. So we already said that pain is
bad. So we already know that'sbad. But if you're actually
visualizing looking at the baby,if we see the actual nipples,
they're not the areola whenwe're talking about anatomy. But
the actual nipple in the cornerof the baby's mouth or the base
of the nipple is actuallyshowing because the baby's so
(08:17):
narrow, and if the baby's mouthor lips look pur- pursed, kind
of like a kiss, that's typicallygoing to be a poor latch or a
shallow latch. And it alsousually results in sort of like
loud smacking sounds, that sortof indicate to us that baby
doesn't have a good feel aroundmom's breast.
Amanda Gorman (08:38):
Okay, so I mean, if if mom is suspecting that the
latch might be off, how longshould she try before reaching
out to get help?
Leah Tribus (08:49):
So it's always good to feel like you have a basis
when you start. Obviously, youdon't want to go into this
completely blind. And maybethat's part of the reason why
you're listening to thispodcast. But it's helpful to
kind of know what is normal andwhat is not. So now that you
understand that, you know,latching shouldn't be painful.
You should never suffer througha feeding because one bad latch
(09:12):
one bad feeding could causedamage to the nipple, and then
we're having to do a lot of workto get mom comfortable again. So
it's always a good idea,especially if you birth in a
hospital or even a birthingcenter to have someone take a
look. If you are unsure if thelatch is correct, if you're
having some pain, ask yournurse, ask the lactation
(09:32):
consultant to come say, hey, howdoes this look? Does this look
correct? Because it's botheringme a little bit so that we can
intervene sooner rather thanlater.
Amanda Gorman (09:41):
Okay, now, I know from my own personal experience,
I actually didn't have problemsin the hospital but they kind of
started once I got home. So whatresources are out there for moms
who don't start to get into thetrouble zone until they are out
of the hospital?
Leah Tribus (09:58):
So I think this is actually a really common
problems. So if anyone'slistening that has a baby and
has gone through this, they'veprobably experienced a similar
issue. There tends to be in thatfirst week of life, a lot of
critical- critical changes whatwith the milk coming in, the
breast getting engorged, andthese sort of things that make
little speed bumps to ourbreastfeeding journey. So I find
(10:19):
that without support, so withouta phone call, a visit to someone
who knows what they're doing,parents are really blindly
trying to navigate, which isreally hard. And it's completely
okay and expected to ask forhelp.
So, I find that there is acouple good sources out there.
One is if it 2am and you'relooking for some solid
(10:42):
information I really, reallylike kellymom.com. It's very
reputable information written bypediatricians, lactation
consultants that haveexperienced. And it's a go to
for me sometimes when I'm notsure of something. So that's a
great place to do some researchrather than Google. Secondly,
most hospitals do offer someoutpatient, at least telephone
(11:04):
support. I know at one of thehospitals that I work, we do
offer that. So at the very levelthat nurse can or lactation
consultant can triage for youand say, hey, I think this
warrants you having a telehealthvisit, or if it's something more
serious, having an actualoutpatient visit. Some
pediatricians office will havelactation consultants on staff
(11:26):
and some pediatricians areactually certified themselves.
But what you have to kind of askyourself is is this person doing
lactation all the time, or justsome of the time? So it's always
good to seek out professionalsthat do this pretty much all the
time, because they're seeing thesame issues and can help you
with them. So I love the idea ofreaching out for maybe some
(11:47):
triage information from thehospital if that's available.
And then going straight totelehealth if it's available,
like with Nest Collaborative,and then they'll let you know.
Do you need to see a person inperson to get a weight check or
any other thing that your babymight need?
Amanda Gorman (12:05):
Okay, that I love it. That's great. And that's
really good for moms to knowwhat their options are once
they're once they're home. Sofor second times moms, is it- is
it the same necessarily from onebaby to another for moms who
were successful with one? Arethey you know, is it pretty much
a sure shot for baby number two,or vice versa? If mom struggles
the first time should she expectthe same issues with her next
(12:29):
baby?
Leah Tribus (12:30):
So that's also a great question because every
baby is different. I explainthis a lot to moms when they get
varied information from onepregnancy to another, from one
baby to another. And I remindthem that we're not robots. So
one solution for one baby mightnot be the solution that works
for another. One problem mightnot be the same exact problem.
(12:51):
So we have to look at each babypretty individually. Now if a
mom had an issue, something withher supply, we are going to
watch her really closely to seeis that going to occur a second
time. But with babies,typically, if it was a mouth
anatomy issue, or just mom notunderstanding that she needs to
ask for help, we can certainlyhelp her earlier on. I have
(13:16):
situations all the time whereparents have had a rough
experience with the first babyknow what to do and what to ask
the second time, and thereforehave better success and are
calmer the second time around.
So it's not always that case, itcan go the opposite. Some of
them have wonderful luck withtheir first baby, my firstborn
was an absolute dream when itcame to breastfeeding. And my
second was a challenge. So youcertainly can have the opposite
(13:39):
happen. And that's where, again,reaching out for support is so
important. Just because you're asecond time mom or third time
mom, doesn't mean that you'renot allowed to ask questions.
Amanda Gorman (13:52):
No, absolutely not. super helpful. Thank you so
much. One more question I havehere is can a baby latch
differently on one boob than shedoes on the other side?
Leah Tribus (14:04):
I mean, again, typically we're not- we are
breast shape, size, nipplesshape, size, might not be
identical. There may be somedifferences also with your
comfort level. So if you'reright handed, you may be more
comfortable in certain holds onthe right breast than you are in
the left breast. And somebabies, some babies can actually
scent that- sense that. So Ithink it's really helpful to
(14:27):
recognize that breast preferenceis what moms will say, my baby
prefers the right, you know, ormy baby prefers the left, is
often something a combination ofmom's anatomy, maybe one nipple
is larger than the othertherefore easier for baby to
take. It could be the amount ofcolostrum coming out of one side
versus the other. And then ontop of that we layer in your
(14:49):
comfort level. Maybe you have anIP in one of your hands and it
makes it a little bit difficult.
So certainly babies can preferor one side can feel easier, but
that does usually level off withgood support, problem solving,
and then once the milk comes in,I do find that babies are a
little less picky, because thevolume is there, and they're
just excited to be fed.
Amanda Gorman (15:11):
Of course, aren't we all? All right. Wow, well
you've really given us a lot tothink about already. I would
like to pivot a little and talkabout the best positions to hold
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Hey, everyone, we are back withLeah Tribus, who has really
given us a fantastic one o oneon what to expect when a baby
latches on the breast for thefirst time. But now I'd like to
change gears a bit and chatabout the hold. And how moms can
(16:40):
support their babies in a waythat's comfortable both for
their little one and themselves.
So Leah, let's start talkingabout the most basic aspect of
holding the baby whilebreastfeeding. Why is
positioning so important for it?
Leah Tribus (16:55):
So it's interesting because I do feel that we focus
always on latching. And it is soimportant. But it's important to
know that without goodpositioning, a good latch can't
be achieved. So they really gohand in hand, it's really you
must have one to have the other.
So I see a lot of moms who haveseen pictures of mom holding
their baby in the crook of theirarm like that traditional cradle
(17:19):
hold. And that's what theirdefault is they kind of go to
that position thinking that'sthe way we all breastfeed. And
it's actually much more thanthat. So I find that, you know,
to get that comfortable latchwe've been talking about, we
really have to focus on bodymechanics. You know, as adults,
we're told how to sit at ourdesk and where our monitor
height should be. And we have toremember that body mechanics for
(17:40):
our newborns, is just asimportant. Babies can't swallow
well or maintain suction whenthey have poor body positioning.
Amanda Gorman (17:51):
Well, that makes total sense as I straighten up
in my chair here. So a lot ofmoms are afraid that their baby
can't breathe while they'refeeding. Is that true? Or, how
can they be assured that baby'sbreathing fine, when it might
not look as though that's thecase?
Leah Tribus (18:08):
Yeah, I mean, that's, that's valid. Some moms
with larger breasts really worryabout that, especially if their
breasts are what we callpillowy, nice and soft, like a
pillow. But again, with properbody mechanics, kind of getting
that asymmetrical latch likewe've chatted about. It will
help facilitate a position inwhere baby's nose isn't buried
(18:28):
in mama's breasts. Also, it'skind of interesting to note that
baby's noses are actually a bitflat at first. And this is
specifically so that- becausethey are meant to kind of press
against mom's breast. And thislets them get a deep latch and
they still can breathe. So mytypical rule of thumb is if you
can semi visualize one nostrilfrom the side, we're pretty
(18:51):
good. And I usually showexamples of you know how you can
breathe. If you put your hand upto your nose, you actually can
still breathe okay. So I'll haveparents kind of try that. So
they can be like, oh, yeah,okay, that baby can breathe.
Amanda Gorman (19:06):
Okay, well, that's easy. What do you think
are really the best positionsfor newborns who are learning to
nurse?
Leah Tribus (19:14):
So I think things that provide good body mechanics
for both mom and baby are thebest. And so my two favorite
holds for newborns are going tobe the cross fetal position and
the football hold. Before I kindof explain what those are, I do
like to explain just kind of thebasics of a hold. So in any
breastfeeding hold, the baby'sbody should be aligned. And what
(19:37):
I mean by that is the baby'sear, shoulder, and the hip
should all be in a line. Thehead should kind of be straight
on and shouldn't be twisting toone side or the other. And
that's important as like thevery basis for effective and
comfortable feeding. And wetalked about before you lining
your nose up with baby's nippleand by aligning your nipple up
(19:58):
with baby's nose, touching thebaby right under the nose, which
will allow baby to lift likethey're sniffing and get that
asymmetrical latch. And wheremom's supporting hand will be is
between baby's shoulder bladeson the back, and the nape of
your baby's neck will restbetween mom's fingers and thumb.
This hold really allowsflexibility of movement for baby
(20:22):
because babies don't rigidlyattach to the breath. And it
allows mom a lot of control overbaby's head and neck versus the
traditional cradle hold, forexample. So both the football
hold and the cross cradle kindof achieve these things, which
is why they're my favorite.
They're also my favorite givenbaby sizes. So a three months
old, you can throw in the crookof your arm, they know how to
(20:42):
self attach, and the cradle ho-hold works just fine. But for
those new tiny babies that needso much assistance to get to the
breast, we really want to makesure that we have full control
if we can. So cross cradle, momshould be slightly reclined,
this always helps- gravity isgoing to help hold baby to mom's
breast. So she'll bring her babytummy- so baby's tummy to mom's
(21:04):
tummy. And when mom looks down,she'll see that good body
alignment we talked about. Andin this way, the baby can push
that chin into the breast, theneck will be extended, and the
nose and forehead will beslightly rocked or angled off
the breast, and the baby laysacross mom's belly. And that's
in that semi reclined position.
(21:27):
And it really once we kind oftweak that and get that right.
It's a beautiful, wonderful,comfortable position. Some
momma's have more successfulfootball, especially if they've
had a cesarean and they'renervous about having the baby
lay on their stomach. So in thefootball hold, the baby's sort
of wrapped around your sideturned into you again. But it's
more like baby's tummy onto yourribs or your side. And you kind
(21:50):
of have them tucked in likethose quarterback people, you
know, run around with thefootball, which is where it got
its name. So but really whatyou're doing is you're- your
supporting arm is holding thebaby close to the body. And the
other hand is going to sandwichyour breast in a V-shape. In any
hold we use when we compress thebreast like a sandwich, it
allows better control of thebreast, and that deeper latch we
(22:13):
keep talking about.
Amanda Gorman (22:15):
So helpful. Thank you. Will- well you just spoke a
little bit about- so it seemsthat positions will change a
little bit as the baby getsolder. Is that something that's
more of a preference for baby orjust natural as the baby grows
and develops.
Leah Tribus (22:33):
Yeah, I think it's really a natural progression. I
think as moms become much morecomfortable with what that latch
is supposed to feel like. Sowhen they start to learn, the
difference between this isreally wrong, or yay, this is
right, then they can start kindof modifying their positioning,
because they know if they make aminor adjustment and it hurts,
(22:54):
oops, I got to change back tothat other hold. So it really
allows moms once they'recomfortable to experiment a
little bit and figure out- Ikind of say there's no wrong
when it comes to latching unlessit hurts or positioning. So moms
are allowed to try a variety ofdifferent things. If it's
working for them, I say go forit. And I find that again, once
you're at home in yourenvironment where you can kind
(23:17):
of freely have no shirt on,snuggle your baby a lot, and
nurse in a variety of places,you will start to develop
preferences. And it's based onboth of you. So I think once
baby can self attach muchbetter. And once you get that
comfortable latch, you reallycan try a bunch of things that
work work very effectively. Butfor that newborn period those
(23:38):
are my favorite.
Amanda Gorman (23:39):
Gotcha. So what about twins? When you're trying
to hold twins do you do one babyat a time? Two babies at once?
What does that look like?
Leah Tribus (23:49):
So that is- that is something of course that twin
moms want to know a lot. Andwhat I find I always try to do
with my clients and patients isprovide for them a achievable
goal. And I think while tandemfeeding is beautiful and
wonderful. It's like we talkedabout with these little bit more
(24:10):
advanced positions that we getinto when we're comfortable. It
sometimes can be tricky, not foreverybody. But in the first
early days, it can be tricky fornew mamas. And I don't ever want
a mom to feel like they're setup for failure. So we always
will practice I tell them to tryto do a little bit of
practicing. But I also allowthem that space to know that if
(24:31):
they need to feed one baby andthen feed the second baby,
that's also totally okay. Soit's really mom's preference.
Tandem feeding can be wonderfuland very time saving when we get
that down when we kind ofachieve that. But understanding
that twins can have a lot ofdifferent nuances, that they're
a little bit early, and thingslike that. That can make a
(24:53):
difference in how often tandemfeeding is successful and that
newborn period. Once we do wantto try it though, the positions
that we talked about work reallywell. Usually you need a much
larger surface area. So somepillows, there's a couple
breastfeeding pillows that aremeant for twins, they give you
more real estate to work with.
And so usually if you havesomeone nearby to help, you can
(25:16):
do the football hold attachingone baby. And then there's the-
your helper can help bring thesecond baby under your other
arm. So you can do football onboth sides. Once they're there,
you do great. You can also doone side football and one side
prop cradle. That also seems towork really well for some mums.
But you definitely need thoselike extra pillows for support.
(25:38):
And sometimes you need an extrahand or two in there to
initially get babies latched.
This also works the same, ifyou're breastfeeding a toddler
and a newborn. You can dovarious positions, depending on
where you're sitting, where yourtoddler is kind of on one side
with the body away from you. Andthen you're you can focus more
(25:59):
on the newborn, because yourtoddler knows how to attach. So
tandem feeding for an olderchild and a baby can be a little
bit simpler.
Amanda Gorman (26:08):
Gotcha. Yeah, we do don't- we know those toddlers
like to move around a lot too.
Leah Tribus (26:13):
Right.
Amanda Gorman (26:14):
So what would you say are some of the kind of
common positioning mistakes thatmoms might be more apt to make?
Leah Tribus (26:23):
So I touched on it a little bit. But that
traditional cradle hole that weso often see pictured, I
actually find I see it a lotwith second time moms. So I have
a second time mom, she comesinto the office telling me, you
know, I feel like I should knowwhat I'm doing. But this latch
that my baby's doing is painful,please help me. And what it ends
(26:45):
up being is that they have thebaby not aligned properly. So
either the baby sort of sittingin their lap with the neck
twisted towards their nipple,and baby's yanking on the nipple
kind of not square on but sortof pulling, or the mom has a
baby in the crook of her arm.
And that cradle hold with thebaby a little bit too far to
mom's armpit. And when thebaby's not in front of the
(27:05):
breast, so I touched on keepingthe nose across from mom's
nipple, when that's nothappening, if the baby brings
the chin to the chest. Soinstead of that sniffing
position, it's kind of theopposite the chin is headed
towards the chest, the nipplegets mashed on the hard palate,
which is not comfortable. And italso results in that more
(27:27):
shallow draw and transfer ofmilk as well. Um so that's
really the most common issue Isee is that chin kind of resting
against the chest, we can'tslide a finger between the chin
and chest, baby's nose is buriedin the breast. And moms are
complaining of this pinching orclamping or biting. And that's
really, really common again,because a lot of times in the
(27:50):
delivery room, you're kind oflike left on your own to figure
out this breastfeeding thing thefirst time. And when that
happens, you're using only whatyou've seen. And you're kind of
assuming what the positioningis. And so that traditional
cradle hold with that chinagainst the chest would be like
the most common issue that I seethat causes discomfort.
Amanda Gorman (28:14):
That makes total sense. Also another great reason
why it's so helpful to have alittle bit of prenatal education
going in, because some of thisstuff you can discuss and know
ahead of time.
Leah Tribus (28:24):
I'm sorry, can you repeat that?
Amanda Gorman (28:25):
I said, it's why it's so good to have some
prenatal education before babyarrives on breastfeeding.
Leah Tribus (28:31):
It's amazing. And I find that moms that are prepped
and come in prepped have alreadystarted that football hold, have
already started the crosscradle, they have minor tweaking
questions. It's really such awonderful resource because your
brain is much clearer duringthat pre baby stage than right
after the baby's born when it'sreally hard to absorb all the
information.
Amanda Gorman (28:51):
Mm hmm. A lot going on. Alright, so baby's
hands, they're always getting inthe way. Do you have any
suggestions for how mom can kindof get them a little bit under
control so she can really workon that latch?
Leah Tribus (29:04):
Yeah, so I've been doing this like, you intro'd me
for a long time. And I havenever done a lot of research
about baby's hands. Just wasn'tsomething that was on my radar.
I knew they got in the way andthat sometimes they were a
barrier, that baby was suckingon the hand instead of kind of
rooting towards mom's breast.
And recently, I found thisarticle by the San Diego
Breastfeeding Center. And it hadthis great information about how
(29:28):
the baby's hands have thispurpose. So they seem like a
nuisance, but they really havethis purpose. Newborns have
really poor eyesight, which allof us probably learn a little
bit in our prenatal research. Sothey have to use all of their
senses to find our breast. Sothey will use their hands to
(29:48):
sort of ground themselves. Ifyou were falling forward, you
would want your hands out. Youwouldn't want your hands behind
your back. So babies use theirhands to ground them. They also
use the hands to search aroundand help them find the breast
and the nipples. So, when babiesget stuck in sort of this like
mood where their hands are upreally tight against their body,
(30:11):
which can happen when they're alittle over hungry, and they're
really gnawing at their hands,if you move your- if you kind of
move your nipple or your breastover to baby's cheek and face,
sometimes that will result inthem moving that hand out of the
way. And then therefore,subsequently latching at the
(30:31):
breath. Um the other thing youcan do is gently let baby grip a
finger. So sometimes I do thiswhen I'm in a consult, and I
gently move the hand up abovethe breast. So I'll usually have
one hand under the breast, andone hand over the breast, kind
of like the baby's hugging thebreast. And that keeps them
really grounded and keep theirmouth and area we need it to be
(30:51):
which is right at the nipple.
Amanda Gorman (30:56):
Helpful, very interesting, because you think
sometimes you just think oh,swaddle that baby, and get those
arms out of the way. But itsounds like that they need them.
Leah Tribus (31:05):
Yeah, and I mean, some moms will swaddle and will
actually like forcibly hold thearms down thinking like that's
going to help the baby. Butoften, this can disorient them.
So, you know, again, imaginehaving your hands tied behind
your back and trying to eat offa plate, it would be pretty
tough.
Amanda Gorman (31:21):
Good point. Okay, so lastly, is there any gear or
accessories that might help babylatch better or help mom hold
better. Anything good for momsto have before baby's arrival?
Leah Tribus (31:35):
So that's a wonderful question. There are a
lot of tools out there. And Ifeel like in the last 10 years,
more and more things have beendeveloped and become available
to mom. I'm always trying tostay up, my youngest is 10 now,
so I'm always trying to ask myfriends that are having babies,
what's the new, what's thescoop? What are the new brand
names and what's going on. Butone thing that has been around
(31:56):
for a long time, and I find veryhelpful is the Breast Friends
Pillow, they have the regularversion and they have a twin
version. And what I like aboutthis pillow is you adjust it to
fit your specific waist. As youlose your baby belly, it will
get- you can tighten it and itwill get smaller. And it
provides really firm support.
And I think that's reallyimportant in the early stages.
(32:19):
Because really soft, squishysupport can be much harder to
kind of manipulate to work foryou. So I don't think you need a
pillow. I think you needpillows, I don't necessarily
think you need a breastfeedingpillow. But if we're getting
one, if you're putting one onyour registry, that's the one I
like. And other than thatregular pillows work great.
(32:43):
Sometimes a regular pillow slidunderneath the Breast Friend
Pillow is really helpful untilthe baby's bigger. But having
some support under your arm,across your your waist is really
helpful because what we don'twant to do is round our back and
try to stretch our breast downto our baby. We've seen images
of bottles our whole lives. Andsometimes I see moms treating
(33:06):
their breasts like they're abottle like they're gonna come
off their body and go down intothe baby's mouth. So to fully
kind of take advantage of all ofbaby's reflexes and innate
features that make them be ableto breastfeed from an early
hours of life, is to bring babyup to you, not yourself down to
the baby. So whatever tools youneed to help facilitate that. I
(33:27):
say go for it and every mom isdifferent. But definitely know
that you're going to need somelike firm back support in your
bed if you're going to try tobreastfeed in bed and then
having something under the babyor under your arms to support
the weight of the baby is alsovery helpful.
Amanda Gorman (33:44):
Awesome, Leah thanks so much. I feel like you
really nailed everything andexplained everything so well.
It's been amazing and I reallythank you for joining us today.
If I may-
Leah Tribus (33:54):
It was fun thanks for having me-
Amanda Gorman (33:55):
Yeah, no, no if our listeners do want to get in
touch with you what is the bestway to do that?
Leah Tribus (34:01):
You can use my email address which is
Leahtribus "Leah Tribus" lc (asin lactation consultant)
@gmail.com.
Amanda Gorman (34:12):
Awesome. Well, excellent. Thank you so much.
Leah Tribus (34:14):
Thank you.
Amanda Gorman (34:15):
To our mamas and mamas-to-be that is all of
today's show for you today. Asyou know by now, we are all
about tackling yourneed-to-knows so please don't be
shy. Reach out to us atwww.breastfeedingunplugged.com
or send us a message on Facebookor Instagram
@breastfeedingunplugged to askyour burning question. Until
(34:36):
next week. It's me Amanda sayingthanks for being with us today.
Boo bye.
[Outro] Breastfeeding Unplugged.
Breastfeeding Unplugged.
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