This mum called me because she fell into all three of these categories - her baby was being supplemented with expressed breastmilk because of very slow gain, nipples were sore which the midwife had put down to baby spending long periods at the breast (with her supposed "perfect latch") and mum instinctively knew something wasn't right that was being missed. Almost as soon as I had stepped through the door mum posed the question that had been bothering her: "everyone keeps telling me everything is fine, but I really don't think she's actually having much milk, yet when I say she doesn't seem to swallow lots, they just keep saying latch looks fine - can it appear fine and yet baby still not take much milk?
|LLLI - Asymmetric latch|
The first clip below shows "nibbling" or ineffective feeding: Baby is doing almost no drinking. A baby who breastfeeds only with this type of sucking could stay on the breast for hours and still not get enough milk. Something needs to be done here and if achieving a better latch, using compression doesn’t help, the baby almost certainly needs to be supplemented (Newman).
Now compare this to the clip below, where baby is doing some really good drinking: The pauses are very long (this is the mouth filling); this baby could spend a very short period of time on the breast and still be getting plenty of milk (Newman)
Note the difference in positioning in these clips. In the first baby is meeting the breast almost vertically - with nose, mouth and chin meeting the breast at the same time. As you can see the baby's nose sites very close to the breast, potentially making it difficult for him to feed well and breathe easily. In the second clip baby's head is flexed back and the chin meets the breast first, the nose is then well clear from the breast tissue. This asymmetric latch means more of the areola below the nipple than above is in baby's mouth - allowing him to milk the breast easily and consume lots of milk.
It's also not always a case of excellent or bad - there can be a whole host of "good" drinkers too, which is another great example of why timing feeds just doesn't work. A baby feeding as per the really good drinking clip is is likely to be satiated super fast, maybe as little as ten minutes - the next clip below shows a "good drinker" - still milking the breast effectively, but not quite as well as the "really good feeding" above (note the shorter pauses) so maybe he will take 20 minutes. The baby in the very first clip is likely never to be truly satiated and may hang around an age and then want to feed again perhaps only an hour later. Please note these times are only examples!