Why Doesn’t a Baby Latch On and Nurse?

Breastfeeding seems like the most natural thing in the world — and it is — but natural isn’t always synonymous with easy. Some babies do not latch on and nurse well. This can be frustrating for their mothers, causing them to abandon nursing entirely. The first four weeks of life are the most common time for throwing in the towel on breastfeeding, according to a February 2005 Pediatrics article. Understanding problems that can arise and working with a lactation consultant can help you succeed as a nursing mother.

Understanding a Good Latch
Breastfeeding is more complicated than sticking a nipple into a baby’s mouth. The baby actually latches to the areola, the brown area around the nipple — not to the nipple itself. Latching to the nipple will cause you pain and cause your baby frustration, because she won’t get any milk out. To latch on properly, she must get enough of the areola into her mouth to massage the milk ducts and get the milk flowing. Positioning the baby properly is essential. Hold her so her abdomen touches yours. Allow her to root for the nipple rather than forcing her mouth toward it. She will turn toward anything that touches her cheek, so as you are touching one cheek with a nipple, don’t allow anything to touch the other cheek. If you do, she won’t know which direction to turn to find the nipple.

Breast Issues
Breasts are made for breastfeeding, so it seems unfair to blame any nursing difficulties on their construction. Some breasts are better built for nursing than others, however, at least at first. Most problems stem from nipple issues and are compounded — in some cases — by breast size. Breastfeeding is one case where more is not better. Large breasts can make it more difficult for your baby to latch on, especially if your nipples retract, or seem to disappear back into the areola rather than protrude. Protruding nipples are easier for your baby to find with his mouth, making it easier for him to latch on to the surrounding areola. When your milk first comes in — a process known as engorgement — your breasts may become so hard and firm that it’s difficult for your baby to get his lips around the areola. Expressing a little milk first can soften the breast tissue a little and make latch-on easier.

Labor Effects
If you had narcotic pain medication during labor, an epidural or general anesthesia for a Cesarean section, your baby might be a little hung over right after birth. Both intravenous narcotic pain medications and epidural anesthesia can temporarily affect a newborn’s early sucking skills, according to a February 2000 article in the “Journal of Human Lactation.” If your baby seems uninterested in latching on or unable to suck well, giving him a little time to recover will probably result in a more successful nursing session. Try not to get frustrated with him or yourself. Consider the first few nursing sessions practice rather than predictors of future nursing success.

Baby’s Issues
Some babies have issues that make a good latch-on more difficult. If your baby was born prematurely, even by just a few weeks, she might not have the coordination to latch on, suck, and swallow all at the same time. Breastfeeding takes more coordination and effort than drinking from a bottle, which drips milk into a baby’s mouth whether she sucks or not. If your baby has a cleft palate or lip or another mouth anomaly, she might have difficulty creating the suction to milk the breast tissue. A baby with Down syndrome or another disorder that causes muscle weakness — such as a heart condition — might not have the strength to maintain a strong latch.