GUIDE
A deep latch — where baby takes a big mouthful of breast, not just the nipple — is the single biggest factor in pain-free, effective breastfeeding.
If breastfeeding hurts, the latch is usually the first thing to check. The good news: most latch problems are fixable with technique adjustments, and it gets easier with practice.
A good breastfeeding latch is the foundation of everything else. It determines whether feeding is comfortable or painful, whether your baby transfers milk efficiently, and whether your supply gets properly stimulated.
Most breastfeeding problems — sore nipples, perceived low supply, frustrated babies, marathon feeds — trace back to latch. Fix the latch, and many other issues resolve on their own. This is why every lactation consultant starts with latch assessment.
And here's the part nobody tells you: latch is a skill, not a reflex. Yes, babies are born with rooting and sucking reflexes. But those reflexes don't guarantee a perfect latch from day one. You and your baby are learning to coordinate a complex physical interaction while you're sleep-deprived and your hormones are doing backflips. It's genuinely hard, and struggling with it doesn't mean you're doing it wrong — it means you're still learning.
Baby's nose should be at nipple level before you start. Their body should face yours — tummy to tummy — with their ear, shoulder, and hip in a straight line. Support their neck and shoulders, not the back of their head (pushing the head can cause them to pull away).
Brush your nipple against baby's upper lip or nose. Wait for them to open WIDE — we're talking yawn-wide. This is the moment. If they open small, wait. It's tempting to shove the breast in when they open partway, but a half-open mouth gives you a shallow latch.
When baby opens wide, quickly bring them toward you so they scoop up a big mouthful of breast from below. Their chin should hit first, with their lower lip far below the nipple. This asymmetric latch is what you want — baby should have more breast tissue below the nipple than above.
Once latched, both lips should be flanged out. If the lower lip is tucked, gently pull down on baby's chin to flip it out. Baby's chin should be pressed into your breast, and their nose should be close to (or lightly touching) the breast but not buried in it.
In the first few days with colostrum, swallows may be quiet and infrequent. Once your milk comes in, you should hear a clear suck-suck-swallow rhythm. If you only hear rapid, light sucking with no swallowing, baby may not be transferring milk effectively.
Slide your finger into the corner of baby's mouth to break the suction before pulling them off. Never pull baby straight off while they're latched — it hurts and can damage your nipple. Take a breath, calm baby if needed, and try again. There's no limit on attempts.
You don't need all of these every single time. But if most describe your typical feed, your latch is working well.
One of these occasionally isn't a crisis. Several of them together, or pain that worsens daily, means it's time to get hands-on help from an IBCLC.
This is the number one cause of painful breastfeeding. Baby needs to take a big mouthful of breast — nipple plus areola. If they're only on the nipple, it will hurt and they won't transfer milk efficiently. Break the seal and relatch deeper.
Your instinct is to push baby's head toward the breast. But babies reflexively push back when you press the back of their head. Instead, support their neck and shoulders, and bring their whole body toward you.
This kills your back and changes the angle of the latch. Instead, bring baby up to breast level using pillows, and lean back slightly. Your back will thank you after three months of nursing.
A partial open gives a shallow latch. Wait for the big yawn. Tease baby's lip with your nipple to trigger a wider opening. It takes patience, especially when baby is screaming, but the latch will be better.
Fingers in a V or scissor grip around the nipple can compress the breast and restrict milk flow. If you need to shape your breast, use a C-hold (thumb on top, fingers underneath, well behind the areola) or a U-hold.
tinylog logs nursing sessions with side and duration so you can tell your lactation consultant exactly what's happening, not a vague approximation.
Sometimes you're doing everything right and the latch still isn't working. Anatomical factors can play a role:
Tongue tie (ankyloglossia): A tight or short frenulum under baby's tongue can restrict tongue movement and prevent a deep latch. Signs include a heart-shaped tongue tip, inability to extend the tongue past the lower lip, and a painful, shallow latch despite correct positioning. See our tongue tie and breastfeeding guide for a detailed look at diagnosis and what the evidence says about revision.
Lip tie: A tight upper lip frenulum can prevent the upper lip from flanging properly. This is less well-studied than tongue tie, and the impact on breastfeeding is debated among experts.
Flat or inverted nipples: These can make initial latching harder, but they don't prevent breastfeeding. Techniques like breast shaping (compressing the breast into a "sandwich"), nipple shields as a temporary bridge, and reverse pressure softening before latching can all help. An IBCLC can show you these techniques hands-on.
Engorgement: When your breasts are very full and firm, baby literally can't get a grip. Hand express or use a pump for just a minute before feeding to soften the areola. This makes a dramatic difference in latch quality.
If there's one latch technique to learn, it's the asymmetric latch (sometimes called the deep latch technique). Here's the concept: baby should take more breast tissue from below the nipple than above it.
When baby latches, their chin hits the breast first, and the bottom lip lands well below the nipple. The top lip lands closer to the nipple. This means the nipple points toward the roof of baby's mouth (the soft palate), which is exactly where it needs to be for effective milk transfer and comfortable nursing.
You achieve this by positioning baby with their nose at nipple level (not their mouth), so when they tip their head back to latch, they scoop from below. It feels counterintuitive at first — like baby is too low — but it produces a deeper, more comfortable latch than centering the nipple on baby's mouth.
This technique alone resolves a significant number of nipple pain complaints. If you're only going to change one thing about your latch, try this.
"Breastfeeding shouldn't hurt at all." It's more nuanced than that. Studies show that some nipple sensitivity in the first 1-2 weeks is common and resolves on its own. What isn't normal is severe, worsening pain that makes you dread feeding. A 2015 study in Breastfeeding Medicine found that initial tenderness was reported by up to 90% of breastfeeding parents in the first week, but persistent pain was strongly associated with shallow latch, tongue tie, or infection — all treatable.
"Nipple shields are a bad idea." Outdated advice. Modern nipple shields, used under guidance from an IBCLC, can be an effective bridge for parents with flat nipples, premature babies, or latch difficulties. A 2016 systematic review found that nipple shields did not significantly reduce milk transfer when properly fitted. The key is using them as a temporary tool with professional support, not as a permanent fix without addressing the underlying latch issue.
"You'll know instinctively if the latch is right." Not necessarily. Research from Kent et al. (2006) shows significant variation in breastfeeding mechanics between individuals. What feels "right" varies based on breast anatomy, baby's mouth size, and positioning. This is why hands-on lactation support is so valuable — an IBCLC can see things you can't feel.
See an IBCLC if: latch is consistently painful beyond the first week, your nipples are cracked or bleeding, baby can't maintain suction, you suspect tongue tie, or baby isn't gaining weight despite frequent feeding. An IBCLC can observe a full feed, assess oral anatomy, and give hands-on repositioning guidance. This is their specialty.
See your pediatrician if: baby isn't gaining weight, has jaundice, seems lethargic, or has fewer diapers than expected. Your pediatrician may refer you to an IBCLC or an ENT if they suspect a tongue tie.
In-hospital lactation support: If you're still in the hospital, request a lactation consultant visit before discharge. Most hospitals have IBCLCs on staff. Don't leave without someone watching a feed — even if nursing "seems fine" in those first hours. A quick check now can prevent problems later.
Getting help early is the single best predictor of long-term breastfeeding success. Don't wait until you're in tears at every feed.
This guide is for informational purposes only and is not a substitute for professional medical advice. If you're experiencing breastfeeding difficulties, consider consulting an IBCLC (International Board Certified Lactation Consultant) or your pediatrician.
