One of the most common and unhelpful things mothers are told by well-meaning nurses, doctors, and friends is that their baby’s latch “looks good” when the mother does not feel confident that nursing is going well. The way the latch looks to the outside observer is completely unimportant. In breastfeeding a full-term healthy infant, only two things matter:

Is everyone comfortable?
Is the baby getting milk?

If you said YES to both, then nurse on proud mama!

Unfortunately, many mothers go on experiencing pain in the nursing relationship because they are told breastfeeding hurts and the latch “looks good.” Pain is not normal. Pain is your body’s way of communicating that something is wrong.

Unfortunately, many babies who are not getting enough milk aren’t evaluated to understand why. The latch may “look good” from the outside, but be ineffective at drawing milk from the breast.

So what’s going on here?
The range of reasons why a “good looking latch” is painful and not effective at transferring milk is wide. Sometimes it’s size, shape, positioning, or maturity. Some babies are born with oral anomalies that make successful latch-on difficult or impossible. These oral anomalies are tiny things that require a skilled health care provider to detect like a tongue tie, lip tie, or bubble palate. These sorts of conditions can make deep latching and adequate milk transfer very difficult. Babies like this nurse frequently, often painfully, and have low diaper count and poor weight gain is any gain at all. Breastfeeding is not working, but it can be fixed.

When the baby doesn’t transfer milk well, the common answer is “low milk supply.” It’s common to assume the mother is not making enough milk rather than check the baby thoroughly. Most experts agree that lactation failure and low milk supply are very rare, but it’s cited as the reason for breastfeeding troubles time and time again. The health care provider says, “The latch looks good! There must not be any milk there.” Again, looking at the latch from the outside tells nothing.

So what does a mother do when breastfeeding hurts and babe isn’t getting milk?

Babies with “hidden” latch problems most often can breastfeed beautifully with a little help from a trained LC, ENT, pediatric dentist, or pediatrician. Mom and baby should work with one of these specialists to identify the cause of the latch-on problem. The specialist will feel inside the baby’s mouth and evaluate the anatomy and sucking. The specialist will do much more than just “look” at the latch. Until the cause can be determined, mom can work with an LC to create a temporary breast-milk feeding plan to feed the baby and protect mom’s long term milk supply. It’s important to remember that oral anomalies are fairly common and most babies can go on to breastfeed full term.