Over and over again, we hear the same question: “Why am I in pain if they tell me my baby is latching on well?

The main causes of breastfeeding pain for mothers are:

• Incorrect breastfeeding positioning: the baby’s body has to maintain a straight line: the ear, shoulder, and hip must remain aligned regardless of the position chosen for breastfeeding.
• Incorrect posture: each breast is different, and for this reason, you should try to trace an imaginary line from the center of your nipple to the baby’s head. If there are any angles in the imaginary line, the nipple will be twisted inside the baby’s mouth. And very importantly, the baby’s chin and nose should be touching the breast.
• Incorrect latch: when your baby latches onto your breast, you should observe how the nipple is directed towards the palate; the baby opens the lips, achieving* an angle greater than 90 degrees, also both lips need to be curled outwards, and the cheeks are rounded.
• Tongue-tie: the presence of a short frenulum (or tongue-tie) may cause the baby to compensate sucking, which is, to counteract the limitations presented by their tongue, they try to use more force or suckle with more force to get the milk out.
• Sucking difficulties: some babies have immature sucking or chewing sucking patterns that cause nipple trauma and a lot of pain.

There is increasing awareness that breastfeeding should never hurt, but we still have a lot of work to do to get women to assimilate this concept. If there is some pain** when you are breastfeeding, it means that something is not right. If this is your case, make sure you find a lactation consultant, IBCLC, or breastfeeding support group, who can help you to assess a feed and find the cause of the pain.

How do I know if my baby is latching on well?

To know if your baby has a good latch, you should keep in mind the following aspects, that will tell you if the latch is good or you can estimate it.

• You should not feel any pain at all.
• The baby’s chin and nose are touching the breast. Babies do not suffocate from being attached to the breast; if they are not comfortable, they will pull away to breathe. So make sure your baby is not restricted, so your little one can move away from the breast whenever needed.
• The baby’s lips are curled outward, both upper and lower lips.
• The baby’s cheeks should be rounded when suckling.
• More of the areola should be visible above the baby’s mouth than below the baby’s mouth.
• The baby’s neck should be well extended, with the head pointing backward.
• And when your baby comes off the breast, your nipple comes out of your baby’s mouth stretched lengthwise, but not squeezed or flattened.

How do I know if something is wrong?

The first sign that something is not going well is pain, if it hurts, something is not right. It is also very easy to see if the baby latches only onto the tip of the nipple alone and places the mouth at a very narrow angle. You can also see if the baby’s cheeks are pulled inward when sucking, just as an adult would do when sucking a liquid with a straw.

It is important that the baby is as close to the mother’s body as possible. The more the baby lies on top of the mother’s body, the more stable they will feel and the easier it will be for them to suckle.

The consequences of a poor latch can also translate into difficulties for the baby to gain weight or the need to suckle all day long to gain some weight.

My baby is not latching on well. What should I do?

First of all, try to get your baby to latch on by themself. Most babies know how to latch on to their mother’s breasts when they are not forced to do so.

Undress yourself from the waist up, and recline at an angle of about 35 degrees so your baby’s body will be lying on top of yours and will feel stable and secure.

Undress your baby, leaving only the diaper on. They should still be asleep when you place them between your breasts, covering both of you. Allow your baby to wake up, and keep a light hold on his/her body, allowing him/her to move freely. You have to watch their movements carefully because sometimes they are abrupt, and they can throw themselves toward a breast.

Gradually your baby will root for the breast until they latch on. During the process, it is important that you look at and talk to your baby, that you encourage and reassure them, if they get upset. Check if your baby latches on better, and if you still have pain or discomfort, book a consultation with a lactation consultant, midwife, or IBCLC, who can help you.

*These observations regarding latch and positioning are true only for the first few months of the baby’s life; from three months onwards, babies suckle as they feel, and this does not usually cause pain to their mothers.

** During the first two weeks of breastfeeding, you may feel a slight pinch when the baby latches on, but this then fades and does not cause discomfort during the rest of the feed. This discomfort has a hormonal origin and is not a latch issue and disappears as the days go by.