Correcting the “latching on” issue may be more complex than currently thought.
A deep latch occurs when the mother’s nipple contacts the baby’s soft palate. It initiates the important suck, swallow, and breathe process. A shallow latch ensues when the nipple only reaches the gums and hard palate.
Some experts recommend that the infant’s jaws open at least 120 degrees, similar to fish lips, when attaching to the areolar tissue of the breast. Limited opening leading to just attaching to the nipple can result in shallow latching.
The major overlooked cause for limited jaw opening is craniosacral fascial strain in either or both temporomandibular joint (TMJ) areas. Since a thin layer of fascia surrounds every muscle cell of the body, fascial restriction of the muscles of mastication can limit opening and result in poor latching.
Our Lancaster research demonstrated that virtually every nursing issue baby had fascial strain in either or both TMJ areas. We believed this fascial restriction was due to birth trauma at delivery, during labor, and/or in utero. If the baby nursed fine on one breast and had trouble nursing on the other, the TMJ strain was usually unilateral.
Other unrecognized fascial factors may simultaneously exist for shallow latching:
1. Hard palate and sinus strain: Fascia can strain into the bones of the hard palate and sinuses. The fascial web connects every structural cell of the body including every osteocyte in every bone. When these tissues release, the maxillary, palatine, and sinus bones can resume optimal function by normally expanding and contracting in sync with the brain motion.
2. Soft palate: Our Lancaster research showed that fascial strain in the soft palatal area can cause an excessive gag reflex, especially with direct nipple contact in the deep latch. The fascial strain here needs to be freed up to allow for optimal soft palatal function.
3. Cheeks and buccal ties: Fascial strain in the cheeks can limit jaw opening. Strain in the buccal ties from the mucosa to the attached gingiva may also contribute. If Gillespie Approach therapy cannot relieve these ties, surgical revision may be required.
4. Tongue: Since the tongue is a series of small muscles, fascial strain can inhibit the normal function of the tongue during breastfeeding. A second factor can be anterior and posterior tongue ties. If they cannot be resolved completely with the Gillespie Approach, surgical revision may be necessary.
5. Floor of the mouth: Strain in the muscles, glands, and other soft tissues of the floor of the mouth may impede proper latching.
The research showed that infants did not open wide enough because their soft tissue restriction caused pain. When the Gillespie Approach for all areas was completed over a series of visits, they comfortably opened for optimal latching and breastfeeding.
A critical therapeutic factor is that fascial strain from below these oral areas may be the primary source of the problem. Thus, the therapist must address the fascial strain patterns originating in the neck, trunk, appendages, and pelvis.
For example, birth trauma causing fascial restriction in the left hip may be straining into the left TMJ and soft palate impeding latching on. For authentic healing, the therapist must connect the dots in the fascial web, since everything in the body is attached to everything else in space and time.
The first Gillespie Approach session, minutes after birth, can help to identify a latching issue, mitigate the effects of trauma, and prevent any subsequent nursing problems. Simply, newborns are tight, and we help to loosen them up. We are waiting for the world to catch on.