Why is Direct Latching an Important Aspect of Breastfeeding?

Assalamualaikum/Greetings.
Its been a while since I've written an entry and I am pleased to do so tonight while my three angels are fast asleep. I have been having this entry in my mind for a while but really haven't had the time nor energy to write up. Thank God for tonight :-)

The reason for this post is recently there has been quite a number of mummies who texted me mentioning they have breastfeeding problems (mostly latching issues). Sadly, some have opted to give up direct latching and continue to exclusively pump without further attempting to consult a lactation counselor to correct the latch.

Really, why is direct breastfeeding important? Nowadays there are so many high technology quality breastpumps around, we can get away with exclusive pumping, can we?

Well the answer is, I am afraid that NOT ALWAYS can we get away with exclusive pumping.

That being said, I do understand when some mothers have to opt for exclusive pumping. I had the "privilege" to experience relactation for my 2nd daughter. We had all the issues with us, starting from premature (weak baby) & drowsy mother (from anti-hypertensive and painkillers) at birth..then baby having a posterior tongue tie (which was difficult to detect), leading to latching issues, nipple injuries, which then led to inefficient breastmilk emptying, fussy baby, and ended up with low milk supply & a very depressed ME. I gave up with breastfeeding when my daughter was 6 weeks old and started relactating when she was 3 months old. During that period, she was bottle fed with formula milk. As I started to relactate, I attempted using the SNS for her, but she furiously refused after multiple attempts, it really broke my heart to force her to latch so I opted for exclusive pumping for the sanity of me to ensure I was happy & baby got the breastmilk she needed.
With God's will, I managed to establish my milk supply when baby was 6 months old and believe it or not, she is now 3 years 11 months and still drinking expressed breastmilk :-)

Needless to say, I DO UNDERSTAND why sometimes Exclusive Pumping happens.

But, I would also love to educate mothers on why direct latching should be the norm and should be attempted first before you actually decide to exclusive pump (if you wish).

This post would be extremely long if I were to write the ALL the benefits of direct latching. Hence, I will just pick on the bits and pieces of imporant facts on why direct latching is so important.

1. Direct Latching allows Skin to Skin Contact which Promotes Bonding, Releases Oxytocin and Endorphins(Love & Happy Hormones).

Just sitting down or lying down, it really feels good to be able to hold your baby in your arms, eye to eye, talking to him or her..it really releases the stresses of life & you get to REST despite how busy the life surrounding you is. Really, it is such a blessing in disguise.!
You just have to sit or lie down and do nothing for that moment while breastfeeding. Just you, your baby and that lovely bonding moment.
It really will promote healthy emotional growth for your infant & ensure you get that boost of love and happy hormones which is good for your emotional health as well! (protects you againts developing post partum depression).
This is why Skin to Skin & Rooming in with baby is precious and much promoted afterbirth!

Human babies and mammals are born with an inbuilt pre-programming to search for and stay closely orally attached to the mother's biological nipple. 

Babies thumb-suck and dummy-suck when they are deprived of the mother's biological nipple.....If a newborn baby cannot have access to it's mother's nipple to love and for enjoyment, comfort and safety, then it is going to find the next best thing to 'love' and this is usually a thumb or a dummy.

Elsie Mobbs RN RM Bsc MStud Psychol PhD

2. Direct Latching Eases your Logistics with Baby :-)

Really mothers, I know how it feels to be stuck to a breastpump 8 times a day. Really its no fun. Especially the part where you have to wash the pump parts so many times a day.
Then imagine outings with your baby. You have to bring along baby, baby stuff (diapers, clothes change etc) and breastpump! Like really, Imagine having to have a pump break, with having to care for baby and then having to feed baby breastmilk using bottle then wash the pump and bottles! Trust me, it is a hassle (despite being such a BLESSING, that you still get to provide breastmilk for your child).

What about night feedings? Think of having to warm up EBM while you are half asleep with a hungry baby crying, then having to wash the bottle afterwards, then pump milk in the middle of the night, and then wash the breastpump parts afterwards. It is indeed challenging and tiring.
I truly admire exclusive pumping mothers for their patience and determination. I have been there and done that, and when I look back, I realize that I only was able to do that with God's will.

With my 3rd baby, Alhamdulillah I am privileged & blessed to be able to directly latch. So my outings are made to ease with just bringing my extra large handbagto put a few baby stuff and my baby in a carrier or sling. No fuss of bringing EBM, ice bricks, hot water, breastpumps, etc.



3. Maintaining Breastmilk Supply.

I have yet to come accross a study/research stating that direct latching is better to ensure your breastmilk supply is sustained longer compared to exclusive pumping.
That being said, logically, when holding baby in your arms, there is so much oxytocin and feelings of love flowing through the bloodstream right? As we know, oxytocin is the hormone essential for breastmilk excretion to happen. Frequent direct latching & loads of oxytocin boost will surely sustain your breastmilk supply right?
Of course using a good quality breastpump would also assist in maintaining breastmilk supply if we frequently empty our breasts with frequent pumping sessions.That being said, I'd choose to cuddle up with baby than being strapped to a pumping machine if I had the choice to do so!



4. Dental Outcomes of Breastfed Children

Babies who were direct latching has better dental outcomes in future as indicated by various studies, studies quoted below. This is because the oral muscles and jaw movements involved in breastfeeding and bottle feeding is very different.

SUCKING AT THE BREAST
Toungue moves forward.
Tip of nipple at junction of hard & soft palate.
Lips wide and flared open.

SUCKING AT THE BOTTLE
Toungue bunched upwards and backwards.
Nipple does not reach junction of hard & soft palate.
Lips not wide and flared open.

Predominant breastfeeding was associated with a lower prevalence of OB, OJ, and MSM, but pacifier use modified these associations. The same findings were noted between exclusive breastfeeding and OJ and between exclusive breastfeeding and crossbite. A lower prevalence of OB was found among children exposed to exclusive breastfeeding from 3 to 5.9 months (33%) and up to 6 months (44%) of age. Those who were exclusively breastfed from 3 to 5.9 months and up to 6 months of age exhibited 41% and 72% lower prevalence of MSM, respectively, than those who were never breastfed.

Exclusive Breastfeeding and Risk of Dental Malocclusion
Karen Glazer Peres et al.

Pediatrics, Volume 136, number 1, July 2015

The acts of breastfeeding and non-nutritive sucking demonstrate opposite effects on oral development. 

Anterior open bite is significantly associated with reduced breastfeeding duration:

• Prevalence of malocclusion was 31.9% in the non-breastfeeding group, 26% for breastfeeding less than 6 months, yet only 6.2% for 3-6 year old who had breastfed for longer than 12 months. 2
• A strong association between any type of non-nutritive sucking habits (on pacifier or thumb/finger) and the development of either anterior open bite, posterior cross-bite or overjet was found in children at average age of 5.9 years.
• Non-nutritive sucking activity, rather than the type of feeding in the first months of life, is the main risk factor for development of altered occlusion and open bite in deciduous dentition. However, children with non-nutritive sucking activity and artificially-fed had more than double the risk of posterior cross-bite. Breastfeeding has a protective effect against development of posterior cross-bite in deciduous dentition. 

1. # Romero CC et al. (2011) Breastfeeding and non-nutritive sucking patterns related to the prevalence of anterior open bite in primary dentition.
2. # Luzzi V et al. (2011) Malocclusions and non-nutritive sucking habits: a preliminary study.
3. # Viggiano D et al. (2004) Breast feeding, bottle feeding, and non-nutritive sucking; effects on occlusion in deciduous dentition

Dental caries

Bottle-feeding or failure to cease use of pacifier before teeth eruption disturbs teeth development. The development of dental caries has the following strong associations:

• pacifier use at 18 months
• prolonged bottle-feeding  and night time bottle-feeding 
• the use of bottle-fed sweet milk drinks and the use of pacifiers.Strep mutan and other caries-related micro-organisms are found in the mouths of children who use pacifiers and prolonged use of feeding bottles with sweetened milk.

1. Yonezu T et al. (2008) Longitudinal study on influence of prolonged non-nutritive sucking habits on dental caries in Japanese children from 1.5 to 3 years of age.
2. # Qadri G et al. (2012) Early childhood caries and feeding practices in kindergarten children.
3. # Mohebbi SZ et al. (2008) Feeding habits as determinants of early childhood caries in a population where prolonged breastfeeding is the norm.
4. # Tyagi R (2008) The prevalence of nursing caries in Davangere preschool children and its relationship with feeding practices and socioeconomic status of the family.
5. # Ersin NK et al. (2006) Association of maternal-child characteristics as a factor in early childhood caries and salivary bacterial counts

Mothers, I truly would suggest that we try our level best to direct latch, seek help if needed and obtain all the support we can before resorting to exclusively pumping.
Needless to say, I know how it feels to be in a situation where I had to exclusively pump. So if you decide to exclusively pump, do it so with pride and CONSISTENCY to ensure that your baby gets the breastmilk he/she deserves :-)

Lots of Love.