Unlocking the Latch: Getting to the root of your feeding pain.

Nothing derails a feeding relationship faster than latch pain, and if you landed on this post, you already know how painful it can be. Toe-curling pain aside, when it hurts it also can send you into a spiral of worry that you are doing something wrong, because ‘feeding is supposed to be natural’.

Feeding your baby is natural, but not always easy, especially without the community support that once existed. The problem is not you or your parenting skills.

In this blog, I’ll share the 4 most common causes of feeding pain and where to get more information, so you and your detective hat can get to the root of your feeding problems.

1. Pain from your nipple being pinched during latching.

This is the most common cause of latch pain, so if you need to start somewhere. Start here first.

Start here even if someone(s) has told you that your latch looks fine, especially if you’ve been taught to stroke your nipple down your baby’s mouth and then compress and shove it inside your baby’s mouth.

What’s likely happening is that instead of your baby opening widely to take a lot of your tissue inside their mouth, their jaw clamps down with their vice-like jaw on your sensitive nipple, which can make the first few seconds of latching feel like someone is stabbing your nipples with shards of broken glass.

If it hurts you, this isn’t just that you have a low pain tolerance. It’s because your nipples are screaming to you that they are being physically damaged, and you want to listen.

How to Help 

Luckily, this can often be quickly fixed once you figure out the right latching approach for your baby and your body. Latching isn’t a one-size-fits-all approach, but I’ve professionally seen a lot of latch pain instantly disappear when parents experiment with a chin-based approach because your baby’s chin comes with a pre-programmed button that cues their mouth to open wide. You can grab my free latching guide for that right here.

A good lactation consultant can also help you find a position that works best for your body. If they shrug and tell you the “latch looks fine” that’s your clue they aren’t the expert you need.

2. Pain from something going on inside the mouth:

How your baby uses the muscles inside of their mouth can also cause pain when feeding.
It seems simple, but feeding requires the coordination of over 20 different muscles during feeding, and the more muscles that aren’t doing their fair share of work, the harder feeding can become.

There are several reasons why muscles aren’t able to work, which can range from your baby being born early and the connection between the brain and the muscles just haven’t finished developing yet, tension in their body (just like if you have a clenched fist, you can’t also move your fingers) to a tongue tie, which is what happens when the tissue under you baby’s tongue is overly restrictive which prevents your baby’s tongue from being able to lift very well. All of those prevent their tongue muscles to be able to do their jobs with ease.

How to Help

Helping the muscles inside of the mouth move better is not a quick fix because you have to first identify why it’s not moving, address that problem and then work to build tone back in the muscles that aren’t moving optimally, and that takes time, but it’s important to understand.

Your baby’s tongue muscles are important for more than just feeding. Your baby uses the same muscles for latching and feeding as they will for eating, drinking from a cup, talking and breathing. Early intervention can help you set your baby up for better longer-term oral function. 

If you think your latch pain could be coming from oral function challenges, a feeding professional who with expertise in oral function can help you create a specific plan for your baby.

NOTE: Not all feeding professionals have the expertise in oral function, so definitely ask about their expertise before you take their opinion to heart. Alternatively, here is a list of folks who have had additional training in oral function.

3. Pain from nipple damage or nipple/areola irritation

If your nipples have skin irritation or damage from latching issues, then latching may hurt until you can heal your nipples. Damage can look like an open sore, but it can also appear as general redness, discoloration, or shape changes in your nipple (it looks more like a cone than a nipple).

The most common causes behind nipple or areola nipple damage are damage from latch compression, irritation or damage from a poorly-fitted pump, allergic reaction to pump parts, inserts or nipple creams, or skin dermatitis on your nipple or areola.

Finding the root cause of your nipple issues can feel like a never-ending scavenger hunt because there are usually a lot of variables when you are feeding your baby that could be the culprit for your issues. You might have a latch that is compressing your nipples and a pump that doesn’t fit, for example.

How to Help 

There are lots of ways to help heal damaged nipples, once you understand what’s causing your pain. Here is an article about some different natural ways to soothe sore nipples.

If you are latching, make sure your latch isn’t causing more damage, and if you are pumping, make sure that your flange fits you well. Most people are using flanges that are way to big for them. Here is a blog post about how to make sure that your pump fits you.

If you need to take a break from feeding directly at your body to heal your nipples, it’s OK to do that, and there are lots of ways that can work for you. Feeding your baby is a choose-your-own-adventure story, and there isn’t a single right way to go about it. Your best outcome will happen if you are working with a lactation specialist to help come up with a plan that helps your nipples heal and doesn’t also accidentally decrease your supply in the process.

If your areola is red, if your skin is flakey, or has raised patches on it, especially if it’s just on one side, that’s a good indication that you should seek out a dermatologist or medical provider with expertise in breast health. Unfortunately, it’s super common for medical providers to dismiss nipple concerns, so don’t be afraid to seek out a different opinion if you aren’t being heard.

4. Pain or discomfort from other medical issues

While the most common reason for latch pain is from the first 3 reasons above, it’s not the only reason why you might feel discomfort from latching.

Other underlying medical conditions can cause latching to be uncomfortable or feel distressing during the latching process, so if you aren’t getting your pain resolved just by working on positioning and supporting your baby’s feeding skills or if you have damage or redness on your nipples that aren’t healing, keep looking for answers.

Feeding babies isn’t designed to hurt, so if your pain persists, there is a reason.

Many medical professionals default to “thrush” (or candida overgrowth) as the root cause of nipple pain, even though newer research suggests that thrush is actually rare. If your professional diagnoses you with this without looking at your body, it’s probably not the correct diagnosis for you, even if you get temporary relief when you apply the antifungal ointment that they offer you.

How to Help

If your pain isn’t going away or is reoccurring, then you may have to do some research on your own to get to the root cause of your problems, as a lot of providers just have so little training in breast and lactation health.

While listing all possibilities that can cause feeding pain is too big for this blog, here are a few you can use as a starting point.

Vasospasms in your nipples and/or your chest muscles (also called Mammary Constriction Syndrome) can cause intense pain both during the latch, after the latch and after feeding. This pain can feel like burning - like when your leg goes to sleep and then ‘wakes’ back up, and can vary from slightly uncomfortable to incredibly intense.

Raynaud’s Syndrome is a phenomenon that occurs when small blood vessels in the nipples constrict excessively in response to cold or stress, leading to discomfort and changes in color—from white to blue, and then red as blood flow returns.

Dysphoric Milk Ejection Reflex (D-MER) is a lesser-known condition that affects some breastfeeding mothers, characterized by an abrupt onset of negative emotions just before milk letdown. Unlike the typical discomfort some mothers may experience with breastfeeding, D-MER is unique because it involves a wave of dysphoria or sadness, that is hormonal in origin and lasts only a few minutes.

No matter what’s behind your feeding pain, there is almost always a pathway forward that can make feeding feel better without sacrificing your feeding relationship with your baby.

If you aren’t working with a good lactation consultant, they will be your best ally in helping you get to the root of your problems and help direct you to other professionals who can help you both solve your problem AND feed your baby how you want.