When It's Not the Latch

Photo used with permission

Photo used with permission

My best friend recently had her first baby. Like many moms, she planned to breastfeed her baby and experienced some pain as she and her baby learned how to breastfeed. Unlike many mothers, however, she continued to experience extreme pain every time she nursed her baby despite repeated trips to a lactation consultant, group breastfeeding sessions and huge amounts of desparate research. After three months of constant and excruciating pain (mostly blamed on latch and sore nipples), my friend was treated for thrush and the pain dissipated within weeks.

The point is that although a poor latch may be a leading cause for breastfeeding discomfort, it is certainly not the only one! Once you’ve established that you have a proper latch but  you are still experiencing discomfort, it’s time to look for another top culprit.    

  1. Lip or tongue tie. Everyone has a piece of skin that attaches the bottom of the tongue to the base of your mouth and another piece of skin that attaches the inside of the upper lip to the gum. See this article for pictures. In some babies, those pieces of skin - known as the frenulum and frenum respectively - extend too far in the mouth and cause a baby to have limited tongue or lip motion, which can cause slow weight gain, “clicking” when baby nurses, poor milk transfer and a fussy baby. To determine if your baby may have a lip or tongue tie, you can take a look in his mouth to see if he has limited tongue motion. However, not all tongue or lip ties can be easily seen, so it’s important to talk to your healthcare provider if your latch is correct but you still suspect a problem.

  2. Plugged Duct or Mastitis. This problem is downright sneaky. It can start off as a vague discomfort in one breast, especially when your baby nurses on that side. Naturally, your first thought is probably to blame the latch, so you focus your attention on that. Before you know it, the tender breast looks a bit red, feels hot to the touch and now it really hurts - both when baby is nursing and when she’s not. That is known as a plugged duct. Now, a plugged duct on its own is painful enough but sometimes these little suckers take it a step further and develop into full fledged mastitis - add all of the above discomforts (tenderness, redness and heat) plus flu-like symptoms such as fever, chills and body aches to that! A plugged duct can be treated at home with warm compresses, rest, frequent nursing and massage; mastitis is treated with antibiotics.

  3. Thrush. Thrush is a yeast infection of the nipples and thrives in warm, moist environments like your nipples and baby’s mouth. Signs of thrush can be shooting pain in your breast when you nurse, white buildup in baby’s mouth, excruciating nipple pain and cracked or blistered nipples.  Some natural ways to treat thrush are topical application of gentian violet, grapefruit seed extract and vinegar. However, if these home remedies fail to clear it up within a week, be sure to seek medical treatment.

It is good and wonderful that there is so much information and awareness about breastfeeding latch but it’s also easy to become too one-minded and blame latch too often. Don’t suffer needlessly if baby’s latch is good and you still experience pain. Look for another culprit; consider one of these three. You just might find the solution!


Happy breastfeeding!