Toddler Tips

Uncomfortable Latch

From NEW BEGINNINGS, Vol. 18 No. 4 July-August 2001, p. 143-145

"Toddler Tips" is a regular feature of the magazine NEW BEGINNINGS, published bimonthly by La Leche League International. In this column, suggestions are offered by readers of NEW BEGINNINGS to help parents of toddlers. Various points of view are presented. Not all of the information may be pertinent to your family's lifestyle. This information is general in nature, and not intended to be advice, medical or otherwise.

Situation

I love breastfeeding my toddler, but lately, it hurts! It seems to be something about her suck. She doesn't nurse often, but when she does, she is really insistent about it. I had the same problem with my older son, but then I thought it was because I was pregnant. I know I'm not pregnant now, but breastfeeding sets my teeth on edge, almost like fingernails on a chalkboard. I will have her latch on several times in an effort to make it more comfortable. We've enjoyed a wonderful breastfeeding experience, but I'm starting to dread it when she gets that look in her eye. Does anyone have any ideas about what could be causing my discomfort or about how to cope?

Response

When my oldest daughter was a nursing toddler there were some times that breastfeeding her was uncomfortable also. First, she began to enjoy "acrobatic nursing" and used her teeth to hang on. We solved this by repositioning and sitting up so that she didn't use me as a jungle gym. Second, when she began to drink out of a sippy cup, she would sometimes treat my nipple like the plastic spout of her cup and suck fairly hard. Encouraging her to latch on properly helped. Sometimes it was almost as though she had nipple confusion! Third, when I was pregnant she did change her sucking pattern to try to get milk.

It seems to me that toddlers often begin to suck differently for many reasons new teeth, a diminishing milk supply, forgetting how to coordinate the tongue and jaw if much time passes between nursings or if they begin using sippy cups. Sometimes just encouraging your toddler to relax and nurse properly and gently can help your jitters go away. Also, perhaps changing your nursing position might help. For us, we had to stop nursing while lying down (a position we used frequently in the past) because it seemed to signal my daughter that it was time to climb. A change to sitting up helped to calm her and let her know it was breastfeeding time, and we'd play after breastfeeding.

Ardie K.
KY USA

Response

You don't say whether this occurs all the time or at intervals. I mention this because when I breastfed my last two children my nipples hurt terribly during the middle of my menstrual cycle, but there was little discomfort the rest of the month. Depending on your child's readiness, you could begin negotiating to shorten the length of the breastfeeding. For example, you might say "you can nurse for a few minutes and then you may have some water." Perhaps buy a new cup with a pretty picture on it to entice her. When my daughter was old enough to count I would say, "Okay, I'll count to 10 (or 20, or whatever works), and let's see who can finish first, me or you." I hope that you will find a solution to this situation; it is so difficult to experience pain during a time that is supposed to feel loving.

Deborah S.-Q.
Canada

Response

I had a similar problem with all my children. I discovered while tandem nursing the first and second children that my oldest child was twisting his tongue when he breastfed. So before nursing I would ask him to open his mouth very wide and stick out his tongue. Then I reminded him to be gentle when he latched on. I tried to find a place to nurse where it was peaceful and quiet so he would concentrate on what he was doing and not absentmindedly start the tongue roll. I also tried to offer to nurse early, before he would ask, so his suck would not be so intense. I made sure I was looking deeply into his eyes so we were truly connected. This eliminated most (but not all) of the pain, but it was so important to him I didn't mind the discomfort. The same problem occurred with subsequent children but I noticed it right away and it never got as bad as it did with the first. My youngest is nine now. How I miss those nursing days!

Rosemarie L.-R.
FL USA

Response

Ouch! That sounds painful and I can relate to your situation. When my daughter was 15 months old, I would unlatch her if she wasn't latched on well. I used to roll away from her and say something like "It hurts me when you don't nurse properly. I don't like it. If you want to nurse then you need to be gentle with my body." I also let her know when she was nursing well by smiling and cuddling he and I told her how much I preferred her gentle latch. It worked for us and taught Maddy the beginnings of negotiation, a skill she will need her whole life.

Jane W.
BC Canada

Response

Once at a La Leche League meeting in my town, the subject of negative feelings about nursing toddlers came up. All of the women in the room were committed to nursing until their children weaned themselves, yet at the same time they all experienced a range of negative emotions. It was dear that these feelings were both very strong and rarely discussed. The top two complaints were discomfort during nursing, and feeling "used" or having little control over the nursing situation. I felt both these things with my first little nursing person. Helping him relatch never solved the problem. It seemed to me that, as he got older, his latch got lazier. I had permanent tooth-marks on my areolas. Around the time he turned three, I felt he was ready to make some changes. First, I started telling him clearly and nonjudgmentally that it was uncomfortable. I'd ask him to relatch ("open really wide, stick out your tongue") a few times if necessary, and if it still hurt, I told him so and ended the nursing session. I also started setting other limits on nursing. I wanted to continue our breastfeeding relationship, but felt I could only do so a finite number of times each day. So I cut out the nursings that bothered me the most, and made breastfeeding available without limits at all other times. Over a few months, I worked on reducing those nursing sessions until we had a predictable pattern. (I feel that this only worked because he was old enough to handle limits.)

I found that once I was no longer constantly expected to provide breastfeeding, and could anticipate how many nursing sessions would occur in the day, I felt much more positive about the whole situation. He went on to nurse happily for another year, until he weaned himself. My second little nursling also makes me feel uncomfortable, but I no longer have the same feelings of frustration. No doubt that was part of growing into motherhood! So I encourage her to "Open really wide, stick out your tongue," and if that doesn't work, I regretfully suggest we move on to some other activity. That usually makes her very eager to nurse nicely! She's also very considerate about kissing the tooth marks to make me feel better if she does happen to hurt me while nursing!

Kristin M.
BC Canada

Response

Nursing a toddler can be really different from nursing an infant. I have nursed four children into toddlerhood, and at times, I have had that antsy, I-just-want-to-get-away feeling during nursing sessions. Sometimes toddlers change the way they suck, maybe because their mouth is getting bigger (and your breast probably isn't!). If your toddler's latch is painful, check for teeth marks or blanching of the tissue. If there appears to be damage, then her latch does need to be adjusted. Changing positions might help, especially if she tends to move around. Changing the places where you nurse might also be necessary. Even in your favorite chair, your toddler might not fit in your lap the way she did when she was smaller.

If there doesn't appear to be any physical damage, try distraction. I have had good luck with this-for myself, not the toddler. Making sure I have a book to read or something else to do while nursing helps to keep me from focusing on the sensations that are annoying. Reminding myself of the reasons that I am choosing to continue breastfeeding this still very little person helps me to adjust my attitude and stay positive.

As babies move into toddlerhood, we also set more limits for them. Often, a quick nursing, say the length of a familiar song, is enough for them to feel connected and is easier for mother to cope with. I have been known to tell an older toddler that I just can't breastfeed any longer right now, but I'd be happy to try again in a little while. I think nurslings understand mothers' feelings in an intuitive way, and they are more cooperative when mothers are honest, but clear and firm.

Remember, just as you think you're stuck in this stage forever, and you can't stand it any longer, ybur child gets a little bit older, and everything changes. Good luck finding a solution that works for you and your toddler!

Cheri S.
MN USA

Response

It sounds as though you are coping remarkably well given how much this is hurting you. There are a number of things I've found that help with a toddler whose teeth are pressing into the breast.

The first is to make sure that she opens her mouth all the way, just like she did when she was a newborn. All three of my children would open their mouths wide when I said "open, ahhh" by the time they were a year old. (Boy, was their pediatrician impressed!)

The next thing to check is that you are nursing with her tummy turned toward you. Proper positioning can make a huge difference. When she is rolled out her head goes with her body and her teeth are more likely to press on your breast.

My final tip for more comfortable toddler nursing is to try and drink enough water. I've never seen a study on this, but lots of mothers I know tell me that nursing a toddler is more comfortable when they are hydrated. It can be especially hard to remember in the summer when you may be busy out in the sun.

Soreness while nursing a toddler can be caused by other things too. Teething can make you sore and you may notice that your nipples get tender while you are ovulating. Sometimes it helps to pay attention to the other things that influence your level of discomfort rather than focusing on the nursing.

Good luck and I hope it gets better soon.

Carrie G.
MD USA

Response

Yikes, it can be difficult sometimes to nurse a toddler. It sounds like you are right on target asking your little one to latch well. Sometimes children at this age are aggressive nursers, and positioning and latch are just as important as when your little one was a newborn. Eventually, depending upon her age, your toddler will outgrow this stage and then gladly comply with your wishes by nursing gently. Some mothers find their nipple discomfort is worse during the premenstrual period and tolerable the rest of the time. Depending upon the child's age, sometimes talking about the situation helps. If a mother feels uncomfortable as she nurses a child, it may make sense to consider weaning. A child can sometimes sense when his mother is hurting and this can be upsetting for him. Some mothers just explain, "It hurts mommy to have 'num num's' (or whatever your child calls nursing) and I can't nurse you anymore unless you nurse more carefully." Most toddlers can understand this and will try very hard to comply. During the time you are working on modoing your child's nursing pattern, your child will need lots of cuddling, and distractions such as walks, books, and substitutions such as snacks.

Ellen N.
WA USA

Response

I sure can identify with your problem! When both of my older two children became toddlers it seems they forgot how to latch on properly and I was frequently left with teeth marks on my breast. My first idea is that you try explaining to your child that she is hurting you when she breastfeeds. You might find that she understands this and tries to be gentler. I also found it helpful to try different positions to see which ones worked best for both of us. You are doing the right thing by taking her off the breast to try repositioning when it is painful. When you put her back to the breast, make sure she opens her mouth wide and takes as much of your breast into her mouth as possible. I found that my toddlers got lazy and often only sucked the end of my nipple. Ouch! I have heard at LLL meetings that painful toddler nursing is a phase and often goes away after a few weeks. You will probably find that with some patience, gentle encouragement, and time, you and your daughter soon become a pain-free nursing couple again.

Tasha G.
CA USA

Last updated November 13, 2006 by njb.

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