Read this article to learn the effect on latching when the mother, or an assistant puts their hand on the back of the baby's head at the time of latching.

When the Back of the Baby's Head is Held to Attach the Baby to the Breast:

• the baby's automatic response may be to push his head backwards against the hand holding his head causing:
  • attachment problems
  • fussy feeding behaviour
  • breast refusal
• three of the reflexes necessary to successful breastfeeding are overridden….
  • the rooting reflex
  • the gape reflex
  • the (tongue) extrusion reflex
• the relative positions of the baby's anatomical features, crucial for his comfort during feeding, become sub-optimal. That is, when positioning is correct, the baby's hyoid bone and thyroid cartilage come forward in relation to his other oral anatomical structures. If the baby's head is inclined slightly backwards, this will be achieved.

However, when the back of the baby's head is held, his head will almost inevitably be inclined forwards...

• the baby's attachment is nose first, chin last, which is entirely the reverse of optimal attachment
• interference with baby's breathing may occur
• Nose-first attachment results in the least optimal attachment for breastfeeding, with the least amount of breast in the baby's mouth, usually just the nipple.
• The mother's experience of nose-first attachment is usually somewhere between discomfort and intense pain.

The mother needs to be taught to hold her baby with one of her hands supporting the baby's upper back and neck, and with no part of this hand higher on the back of the baby's head than the base of the skull. Even one of her fingers resting against the back of the baby's head (higher than the base of the skull) is enough to compromise good attachment.

Robyn Noble DMLT,BAppSc(MedSc),IBCLC
Anne Bovey BspThy
Bayside Breastfeeding Clinic, Manly West, Brisbane
Ph/Fax 3396 9718