Breastfeeding Shouldn’t Hurt: Understanding the Latch and Finding Comfort

By Dr. Leigh Campbell, MD, IBCLC, NABBLM-C, PMH-CFounder, Bloom & Grow Lactation Medicine — Ridgeland, MS

Breastfeeding comfort is possible without harsh interventions.

YOU DESERVE COMFORT AND CONFIDENCE AT EVERY FEEDING

Breastfeeding should nurture and connect, not cause pain. While some tenderness in the first few days can be part of learning, ongoing pain is a signal that something in the fit and function of feeding needs attention.

I’m Dr. Leigh Campbell, a breastfeeding medicine physician. One of the most common reasons families come to see me is because feeding hurts. My message, backed by the latest research, is simple: breastfeeding pain is not normal. Improving latch and positional stability resolves it in most cases without surgery or medication.

Why the Latch Matters Most

Extensive studies from the Possums Neuroprotective Developmental Care (NDC) program and Gestalt Breastfeeding (Douglas et al., 2022–2024) confirm this. Mechanical forces, not infection or anatomy alone, are the main cause of nipple and breast pain.

If a baby's latch is shallow or unstable, the tongue and hard palate compress the nipple. This creates friction, blanching, cracks, and pain. Babies do not extract milk by squeezing the nipple. Optimal breastfeeding involves creating a gentle oral vacuum, drawing the nipple deeply, and maintaining stable suction for milk flow.

This concept, published by Professor Donna Geddes and the team at the Geddes Hartmann Human Lactation Research Group at the University of Western Australia, has revolutionized our understanding of infant feeding. Ultrasound and pressure studies show that effective milk transfer depends on vacuum generation, not nipple compression.

When the baby's entire body is aligned, close, and stable, a deep vacuum forms during positioning, reducing pain and improving feeding efficiency.

What a Painful Latch Feels Like

You may notice:

• A pinching, biting, or sharp pulling sensation.

• Nipples that appear flattened, creased, or blanched after feeds.

• Ongoing burning or throbbing pain post-feed.

  
  

These are nearly always signs of excess compression, competing force vectors or loss of positional stability — not infection or yeast.

Common Myths About Breast Pain

Myth #1 — “Yeast is causing my nipple pain.”True Candida infection of the nipple is extremely rare. Unbalanced mechanical forces or vasospasm cause most “burning” pain from an inefficient latch. Antifungal treatment is often unnecessary, can cause dermatitis, and delays real improvement. In fact, infection of the nipple from any organism is uncommon, in part secondary to the body’s excellent blood supply of the nipple and areola complex. 

Myth #2 — “It must be a tongue-tie.”While some infants have genuine oral restrictions, research now shows that tongue-tie releases are being performed at unprecedented rates, often without standardized assessment and before a mother’s milk even transitions. Most feeding pain resolves through correcting fit and hold, not surgery.

The Evidence-Based Fix: Optimizing the Intraoral Vacuum

Breastfeeding that focuses on optimizing the biomechanics of infant suck and the fit between mother and baby — how their bodies stabilize together, rather than the mouth alone.

With subtle adjustments, parents often notice immediate relief and better milk flow. The goals are to:

• Achieve positional stability for the baby’s whole body.

• Encourage infant feeding reflexes

• Support and infant-led latch

• Reduce friction and nipple distortion through vacuum formation

• Promote calmer, more efficient feeds for both parent and baby.

  
  

When to Seek Professional Support

Dr. Leigh R. Campbell with University of Western Australia professor Donna Geddes.

If you’ve tried adjusting positions and are still experiencing pain, that’s a sign to seek physician-level lactation support. In our visits, I:

• Assess latch biomechanics 

• Rule out over-diagnosed conditions such as “breast yeast” or tongue-tie.

• Treat medical issues like mastitis, vasospasm, or dermatitis when present.

• Design an individualized approach to restore comfort and confidence.

  
  

Your Experience Matters

Painful feeds can affect your physical comfort, your confidence, and your connection with your baby. As a Perinatal Mental Health-Certified (PMH-C) physician, I recognize that emotional well-being and lactation success go hand in hand.

You do not need to suffer through pain. There is no need for unnecessary

medication or surgery. You need accurate, evidence-based care that supports your physiology and your goals. 

Book your appointment today!

📚 Reference List

1. Betts RC, Johnson HM, Eglash A, Mitchell KB. It's Not Yeast: Retrospective Cohort Study of Lactating Women with Persistent Nipple and Breast Pain. Breastfeed Med. 2021 Apr;16(4):318-324. doi: 10.1089/bfm.2020.0160.

2. Crawford E, Whittingham K, Pallett E, Douglas P, Creedy DK. An evaluation of Neuroprotective Developmental Care (NDC/Possums Programs) in the First 12 Months of Life. Matern Child Health J. 2022 Jan;26(1):110-123. doi: 10.1007/s10995-021-03230-3.

3. Douglas P, Keogh R. Gestalt Breastfeeding: Helping Mothers and Infants Optimize Positional Stability and Intraoral Breast Tissue Volume for Effective, Pain-Free Milk Transfer. J Hum Lact. 2017 Aug;33(3):509-518. doi: 10.1177/0890334417707958.

4. Geddes DT, Kent JC, Mitoulas LR, Hartmann PE. Tongue movement and intra-oral vacuum in breastfeeding infants. Early Hum Dev. 2008 Jul;84(7):471-7. doi: 10.1016/j.earlhumdev.2007.12.008.

5. Thomas J, Bunik M, Holmes A, et al. Identification and Management of Ankyloglossia and Its Effect on Breastfeeding in Infants: Clinical Report. Pediatrics. 2024 Aug 1;154(2):e2024067605. doi: 10.1542/peds.2024-067605.