How to achieve the perfect latch by Rebecca Glover RN RM IBCLC
During her Midwifery training in 1970, Rebecca was taught a particular technique for attaching babies that consistently produced a comfortable breastfeeding relationship. Fifteen years later, the ultrasound studies of M.W. Woolridge (Midwifery, 1986, 2., 164-176) described exactly why this technique was so effective. This exciting new information prompted Rebecca to become an International Board Certified Lactation Consultant (IBCLC) in 1989 and to begin her range of educational aids.
Rebecca runs a busy private practice in Perth, Western Australia, consulting to mothers with breastfeeding difficulties (most related in some way to attachment), teaching antenatal classes, conducting workshops and speaking to health professionals.
I discovered Rebecca Glover’s superb approach to achieving the perfect latch when I watched her video at my La Leche League Peer Support Course. I saw it again recently at a Breastfeeding Study day for Healthcare professionals at UCH, and it was great to see the “aha moment” rippling across the room as the many midwives and nurses saw demonstrated the clearest example of the perfect latch that I’ve ever seen.
L.A.T.CH.O. – Learned Attachment Techniques CHanges Outcomes
Breastfeeding Natural? YES! – Comes Naturally? NO!
For a mother, breastfeeding is a learned behavior, but for her baby, breastfeeding is instinctive.
Natures way for mothers to learn is by subconsciously observing other mothers holding, positioning, and attaching their babies successfully.
Unfortunately, almost every human culture has interfered with this natural process, and today many women don’t have the opportunity to learn to breastfeed naturally. Mothers certainly don’t understand how to work with their baby’s innate behaviors, unless someone explains it to them.
Today, health professionals and lay counselors in this field, play an absolutely crucial role in replacing the loss of the natural process, by teaching mothers attachment techniques that support innate infant behavior and the “mechanics” of breastfeeding.
Follow Me, Mum; I do this instinctively!
Mothers need to know how to support and work with their baby’s instinctive behaviors.
The first 3-4months of life is a unique period for the human infant. When feeding behavior is entirely instinctive and reflex, and the infant’s anatomy is uniquely matched to these behaviors .22.214.171.124.7. These reflex behaviors are dependent on; appropriate sensory input, adequate positional stability and the maturity and functionality of the physical structures involved.
When 0 to 3-4-month-old infants are provided with the appropriate sensory input, (“skin to skin” or firm contact with the mothers’ body and breast) they instinctively search for the breast by lifting their heads and thrusting the chin and mouth forward, which in turn has the effect of tilting the head backward. This “Instinctive Position” or posture anatomically matches the processes required for good attachment and the “suck-swallow-breathe” cycles that are breastfeeding.
The Head tilt – extension or flexion
When a baby lifts the chin and mouth towards the breast, this has the effect of tilting the head backward. The perception that this puts the infant into extension, rather than flexion, has caused a lot of consternation. Lift your chin and mouth as if searching for the breast and you will experience that your cervical vertebrae stretch forward as your head tilts backward. When a baby is brought to the breast with their hips and shoulders against mothers’ body, and lift their chin and mouth, to search for the breast, they are simply stretching the cervical spine forward; a very different scenario from extension, when a baby throws its head and shoulders back away from the breast.
To make Good Attachment physically possible babies need to be brought to the breast in the “instinctive position,” where the mouth opens wide, the tongue extends forward, and baby can “scoop” a large amount of breast over the tongue and lower jaw.
The nipple rolls back, close to the junction of the hard & soft palate, and the breast fills baby’s mouth, with the tongue & lower jaw positioned deep under the milk ducts and breast tissue immediately behind the nipple. (see Rebecca’s unique graphics) Attachment is not physically possible with the chin down, and try swallowing with your chin dropped towards your chest!
With the essential mouthful in place, (appropriate sensory input – everything touching in baby’s mouth) the infant responds, using the combination of; negative pressure in the pharynx, the mothers’ milk ejection reflex and the mechanical action of the lower jaw & tongue to comfortably and effectively breastfeed.3.4.
The Magic of Positional Stability
The newborn infant is totally reliant on external support, positional stability.
Without a stable base, function and mobility are less controlled or even impossible. Therefore, for the infant to execute the complex oro-motor movements required for attachment and breastfeeding they must be provided with the appropriate stability.
Oral Stability is dependent on neck and shoulder girdle stability, which are in turn, dependant on a trunk and pelvic stability.
To support the reflex behaviors for effective Breastfeeding infants require:
- Midline Stability – body, centrally straight from head to toe The symmetrical movement of the muscles on both sides of the baby’s body is crucial for optimal oro-motor function
- Shoulder Girdle Stability – firm support in the middle of baby’s body between the shoulders. This stabilizes the neck, head, jaw, tongue, pharynx & larynx to enable controlled and effective oro-motor movement
- Trunk and Pelvic Stability – shoulders and hips turned towards and supported against the mothers’ body.
When a mother brings her naught to three to four-month-old baby to the breast in the “instinctive position” AND provides them with the necessary positional stability, it triggers and supports the innate sequence of reflex behaviors that are breastfeeding.7.
Watching a mother and baby put these learned techniques into practice, it is pure magic to behold; especially when major attachment difficulties are resolved through such a simple and empowering intervention.