Learning session today at 2:00 PM
|
| |
 We will continue to focus on ways to increase frequency of feedings in the first 24 hours of life, as well as consider latch and hand expression techniques for all staff to increase their competency to support the nursing dyad. Click here to join the webinar. The phone conference number is 712-432-6100, access code 96875#.
|
| Shared by Miriam Labbok, MD |
| |
 A baby will latch properly - all else being equal - if they are allowed to be in charge. Our job - and their mother's job - is to support this somewhat uncoordinated little creature to achieve what they wish to achieve: effective latch. Also, all else being equal, the baby will be at the mother's side, able to suckle, empty the breast, and thus supporting the production of more milk, at all times. Fortunately or unfortunately, all else is rarely equal, so we have some tools to help out our observation and support skills.
LATCH: There are many tools for observing and assessing the baby's latch. Luckily, most difficulties are readily observable, but some take special skills to identify. Are we all comfortable with all aspects of LATCH?
LATCH is a breastfeeding scoring system that provides a systematic method for assessing and recording a breastfeeding session. A numerical score of 0, 1, or 2, is assigned, based on observation of five key components of breastfeeding:
"L" is for how well the infant latches onto the breast - what do you see of the baby's cheeks and of the areola?
"A" is for the amount of audible swallowing noted - is there a pattern?
"T" is for the mother's nipple type - if normal, what do you see? Is there blanching? If inverted, does the baby get it to protrude?
"C" is for the mother's level of comfort - pain is NOT necessary and should be addressed.
"H" is for the amount of help the mother needs to hold her infant to the breast - if all goes well the baby has solid suction, with only support needed..
In general, the mom can be prepared to support the baby by ensuring that the baby's nose is "facing" the nipple before the mouth opens. Many moms choose to hold the breast as a "sandwich" for the baby's mouth. Once the mouth is wide open, bring the baby to the breast, not vice versa. The baby should be in a drinking position, with its head slightly back, just like when you drink. If you figure that the nipple in the mouth needs to be generally pointed towards the juncture of the hard and soft palate, you can figure out the direction. Once the latch is well established, you should see a bit more of the areola at the nose side of things, but the baby may well be pretty much squashed against the breast - this is okay, since newborns are obligate nose breathers, and they their noses flange, so they breathe from the side! Cheeks are not sucked in and you do not hear clicking or smacking noises, but rather, if you listen carefully, you can hear swallowing. At the end of the feed, the baby should act relaxed: with open relaxed hands, the baby falls asleep.
There are a lot of videos on YouTube as well. Some have good latches, some poor. For example, you should be able to observe this video and see why there is pain. Why not test yourself?
Also, please review the resource (Stanford Videos shared previously) by Jane Morton on hand expression, even for those who express by pump. More next week!!
|
| Contact |
|
 Karen Metzguer
PQCNC Improvement Advisor
metzguer@med.unc.edu
Work: 919-966-8391
Mobile: 919-619-6332
|
