If you think about what your baby has to do to breastfeed, it’s almost like a carnival trick. He has to latch onto you, and the two of you have to work in unison for the process to go as intended. True, there are reflexes and hormones and all that good stuff, but they are merely parts of the whole “machine.” I’m going to walk you step by step through the mechanics of this “machine” so you can understand how it works and why it fails. And believe it or not, it almost always fails for the same reason.
The first step is your baby’s gape. It is a reflex, which means that he automatically opens his mouth so wide, his jaw disengages- snakelike- to get around your enormously engorged breasts. He has to get that wide because the ducts, the tubes that carry the milk, are buried in your breast tissue. Once his mouth is “latched”, he uses his tongue to press your breast against the roof of his mouth and pulls his tongue back to compress the milk out. Once his tongue is as far back as it can go, his jaw drops, creating a vacuum, that pulls even more milk out.
But your breasts are working too. When you baby’s latches on correctly, that pleasant sensation stimulates touch receptors on your nipple and areola, which in turn stimulate your brain to secrete a hormone. That hormone is called oxytocin, and it travels back to your breast and stimulates the muscles around the little pools, or alveoli, where your milk is made to push out the milk. This is called the letdown. Since these pools are deep in your breasts, there is no way to squeeze them out or suck them out. (This is why pumping alone doesn’t really empty your breasts). And if you feel pain, your brain won’t secrete much oxytocin, so your breasts hold onto the milk instead of pushing it out.
So what happens when this mechanism breaks down? Why do so many women have pain when the baby latches? Why are some babies unable to extract the milk like they should? The answer almost always goes back to the inital reflex: the gape. Some babies just cannot gape wide enough to disengage their jaw to get around their own mother’s breast(s). It is not something they learn or grow into. When they are born, either they can do it or they can’t. And since we are living an age when mothers want to breastfeed their own babies (as opposed to past fixes like wet nurses, other lactating family members, or formula) the fit is everything.
Why can’t every baby unhinge their jaw to get around their own mother’s lactating breasts? Probably for the same reason not every baby can come out of the birth canal without a little help.
Even though both childbirth and breastfeeding are natural, nature isn’t perfect. Just like childbirth, breastfeeding is a two person experience. Sometimes things work out perfectly, and sometimes they don’t. It all boils down to anatomy. If the anatomy doesn’t fit, it won’t change or grow or stretch on its own.
So who diagnoses the problem? If you said your pediatrician, labor and delivery nurse, or lactation consultant, you are wrong. The truth is YOU DO! If your baby can’t open wide, or opens wide then slides down to the nipple each time, you feel the diagnosis. It hurts, it’s frustrating, you nurse forever and your baby is still hungry. The fact is, no one can see a latch from the outside. Only you can feel it. If you feel there is a problem, then there is a problem. And now you can understand why.