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Book Review: The Latch and Other Keys to Breastfeeding Success

Jack Newman, MD, and Teresa Pitman
Softcover, 219 pages
Hale Publishing 2006

Reviewed by Missy Thomas
Bellevue NE USA
From LEAVEN, Vol 43 No. 4, October-November-December 2007, p. 82

As an LLL Leader, it can be discouraging to see a new mother give up on breastfeeding in the early days and weeks after a baby's birth. We've all helped the mother with sore nipples, the baby who refuses to nurse, the one who is not gaining well, or the mother who doesn't have enough milk and is already supplementing by the time she contacts LLL. Why is early cessation too often the case, and what can be done to assist mothers with initial breastfeeding challenges?

The Latch and Other Keys to Breastfeeding Success is an excellent resource to help anyone who routinely works with breastfeeding mothers and their babies answer that question. Dr. Jack Newman and co-author Teresa Pitman have helped thousands of new mothers over the years, and they have compiled this book based on those experiences. They are convinced that the techniques included can help almost any new mother in almost any breastfeeding situation.

The book includes a significant review of birthing practices and how they impact the crucial early days of breastfeeding. The authors promote mother-baby togetherness right from the start, encouraging mothers to begin skin-to-skin contact immediately following birth and to room-in with their babies in the hospital. Mothers who undergo cesarean sections are encouraged to begin skin-to-skin contact as early as while the incision is being closed. According to The Latch and Other Keys to Breastfeeding Success, there is rarely a situation in which this cannot be accomplished.

The chapter, "What is a good latch, and why is it important?" includes some excellent illustrations of a latch. Wonderful pictures of the "asymmetric" latch that is so important -- yet often difficult to explain -- may prove extremely valuable to a Leader helping a mother who is having issues latching her baby onto the breast. The "mother's view while latching baby" is the most outstanding of all the illustrations in this book. All of the easy to understand drawings demonstrate what the latch should look like from a mother's perspective, not from the observer's point of view.

Newman and Pitman go on to explain how to correctly assess a latch and some common causes of incorrect latches. They include descriptions of tongue-tie (along with some very good photos), flat nipples (which Dr. Newman believes is much more often than not an incorrect diagnosis), cleft lip, and cleft palate.

In the quest to empower mothers to learn to trust themselves and their babies, it's particularly important that Leaders know how to help mothers learn to latch on their own babies. This book clearly supports that, as the authors state:

However skilled you may be at helping babies latch on correctly and effectively, ultimately the mother needs to be able to latch her baby on her own. For some mothers, having someone else latch the baby on once or twice will be all they need to "get it"...Others, though will find that even though everything worked perfectly while they were in the hospital or at the clinic (and getting step-by-step guidance from you), once they get home, it all falls apart.

Thus begins this tremendously informative chapter about how to help mothers learn the skills they need to latch their babies onto the breast unassisted. The authors suggest hints such as putting your hands over the mother's hands so that she feels exactly what you're doing, how you position the baby, and how much pressure you're exerting. They give examples of analogies you can use to help the mother understand what the baby is trying to accomplish, such as reminding the mother what she does when she wants to take a big gulp of a drink -- she tilts her head back and drinks.

Newman and Pitman also address legitimate causes of mothers not producing enough milk. They point out that these cases are rare. Most often, "not enough milk" is the case of the baby not getting what is available because of an incorrect latch on. However, there are some causes of poor milk production, such as breast reduction surgery, breast augmentation, thyroid problems, and polycystic ovarian syndrome, among others. Newman and Pitman emphasize that even in these situations, until the "Protocol for 'Not Enough Milk,'" a four-step process that is clearly outlined in the book, is followed supplementation should not be considered.

The book ends with breastfeeding issues for mothers with older babies. The chapter on babies who are experiencing slow weight gain after an early period of adequate weight gain reminds us that just because a mother and baby have made it through the initial postpartum phase doesn't mean problems still can't arise. The last chapter deals with an older baby who refuses to eat solids. The authors do an excellent job debunking the myth that a baby "needs" solids at a certain point and that he will somehow be nutritionally deficient if he does not eat solids at that predetermined time.

The Latch and Other Keys to Breastfeeding Success not only addresses common problems, it gives the tools to help resolve them. It is geared toward health professionals, but the illustrations and lists inside would be perfectly appropriate for most mothers. This book would make a wonderful addition to the library of any pediatrician, obstetrician, midwife, LLL Leader, lactation consultant, or anyone else that routinely helps a nursing mother and baby. Whether it is a newborn or an older baby, this book has something to offer for everyone.

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