Tongue Tie and Latching: Why Nursing Can Feel So Hard
Many parents expect nursing to come naturally. When it doesn't, and latching is painful, frustrating, or doesn't seem to be working, it's easy to feel like something is wrong with you or your baby.
Latching difficulties are very common, and they have many possible causes. Tongue tie is one of them, but it's far from the only one. Here's what parents should know about how latch works, what can get in the way, and who can help.
What happens during a good latch
A comfortable, effective latch is a whole-body skill. During nursing, a baby typically:
Opens their mouth wide to take in a good portion of breast tissue, not just the nipple
Extends their tongue forward over the lower gum to cushion the breast
Cups the tongue around the breast to help create a seal
Moves the tongue and jaw in a wave-like motion to help draw out milk
Coordinates sucking, swallowing, and breathing in a steady rhythm
Babies also need a stable, well-supported body to do all this. Head, neck, shoulders, and jaw all play a part.
How tongue movement can affect latch
If a baby's tongue can't move freely, whether because of a tight frenulum or other factors like muscle tension or coordination, they may have trouble with some of these steps. For example, a baby who can't extend their tongue well may latch more shallowly, or a baby who can't maintain a seal may slip off the breast.
Remember that a frenulum that looks tight doesn't automatically cause latch problems, and a baby with latch difficulties may have a perfectly typical frenulum. Only a physician or dentist can diagnose tongue tie.
How a shallow latch can show up
When tongue movement makes it hard for a baby to latch deeply, families often notice the latch itself feels off. Your baby may slip down to the nipple partway through a feed, or keep coming on and off the breast. You might hear clicking as the seal breaks. Nursing may pinch or hurt throughout the feed, and your nipple may look flattened or creased when your baby comes off.
These latch patterns can have many causes, and tongue tie is only one of them. For a full checklist of what parents commonly notice, including signs in your baby's mouth and during bottle-feeding, see [Does Your Baby Have Tongue Tie? Signs and Symptoms to Know].
Other reasons latching can be hard
Before assuming tongue tie is the cause, it helps to know how many things can affect latch:
Positioning and how your baby's body is supported
Body tension or a baby who seems stiff or uncomfortable
Nipple shape or breast fullness, including engorgement
Birth experience, prematurity, or a sleepy newborn
Nasal congestion that makes breathing while feeding harder
How calm or alert your baby is at feeding time
This is why a team approach matters. Sorting out the "why" helps you find the right solution.
What parents can try
These general strategies help many families. Your lactation consultant can tailor them to you and your baby.
Try different positions. Football hold, cross-cradle, and laid-back (reclined) positions all give babies different kinds of support.
Bring your baby close. Holding your baby close in skin to skin prior to the feed, with their body facing yours, can make latching easier.
Support your baby's body. A baby whose head, neck, and body are well aligned and supported often latches more easily.
Wait for a wide mouth. Bringing your baby to the breast as they open wide can help them take in more breast tissue. Ensure they are free to extend their neck by supporting them on the upper back and not the back of their heads. This helps with a wide open mouth.
Feed early. Offering the breast at early hunger cues, before your baby is upset, can make latching calmer.
Break the seal gently. If the latch hurts, slide a clean finger into the corner of your baby's mouth to release the suction, then try again.
When to call your pediatrician right away
Contact your pediatrician promptly if your baby isn't gaining weight as expected, has fewer wet or dirty diapers, is hard to wake for feeds, coughs or chokes often during feeds, or has trouble breathing while eating.
Your feeding team: who can help
A lactation consultant (IBCLC) is often your first and most important support for latch, positioning, milk supply, and a feeding plan.
Your pediatrician monitors your baby's growth and health and can make referrals.
A physician or dentist evaluates for tongue tie and decides whether a release is appropriate.
An occupational therapist supports your baby's feeding skills alongside your lactation consultant. An OT looks at how your baby uses their mouth and body during nursing, including oral-motor skills, posture, muscle tension, and suck-swallow-breathe coordination, and can suggest ways to support your baby's body during feeds. An OT doesn't diagnose tongue tie or decide on a release, but can share observations of a comprehensive functional oral motor assessment with your baby's care team.
You're not doing it wrong
Latching struggles are not a sign of failure. With the right support, many families find a way forward, whether that's adjusting positioning, working with a lactation consultant, adding feeding support, or exploring other options with their baby's providers.
If nursing has become painful or stressful, contact us to learn how infant feeding support can help.
