1 month-old just learned to latch, but latch is poor/shallow

[@llli*sgl.msl]

My 1 month-old just learned to latch well enough to meaningfully breastfeed with a nipple shield (we'd been doing primarily pump-and-feed prior). After a few days of mostly breastfeeding, I noticed some pain, and the left nipple gets creased/compressed and right nipple is lipstick-shaped after he comes off. I've tried many positions and many re-latches, the "breast sandwich" and "lower-jaw-first" techniques... Even with a good initial latch he eventually slides back to the base of the nipple. He's getting plenty of milk, but the latch is clearly wrong. Should I allow him to keep feeding with the bad latch and hope it straightens out as he grows? Or should I take him off the breast (shield) every time I notice a bad latch? Is the nipple shield the problem?

[@llli*lllmeg]

The nipple shield may be part of the problem, but if you cannot get baby to latch without the shield yet, I would not suggest jettisoning it yet, especially because getting baby to latch and nurse at all is such great progress in your situation.

What positions have you tried? If the problem involves baby sliding off the nipple, laid back nursing often helps with this. if you have tried laid back and it did not 'work' for some reason, let me know what you tried, exactly, and what happened.

Should I allow him to keep feeding with the bad latch and hope it straightens out as he grows?

As long as baby is getting enough milk and nursing is not painful/causing injury to you, this would be a fine course of action. I know there is some pain, but as long as it is something you can live with and it does not worsen you can keep going this way if you like. Latch often DOES more or less “self correct,” overtime, and if baby is not yet able to latch perfectly yet, constantly taking baby off may only result in frustration for you both. But it is really going to depend how it feels.

Also make sure you are nursing baby very frequently. (Normal frequency at this age would be at least 10 times in 24 hours.) If something is fatiguing baby over the course of a nursing session, more frequent nursing might result in shorter sessions and less fatigue. Of course frequent sessions are good in general for more milk into baby and for milk production overall as well.

Things to watch out for- nipple pain getting worse and/or nipple injury

- milk production. Use of nipple shields have been linked to a lowering of milk production in some mothers. So you may need to keep pumping at least somewhat to ensure milk is still being removed from the breasts well enough to ensure good production going forward

Physical barrier-has baby been checked for tongue or lip tie? are you seeing an IBCLC?