Breastfeeding Challenges We Don’t Talk About
Breastfeeding is often portrayed as natural and effortless—but for many parents, the reality is a little more complicated. While we hear a lot about latch issues or milk supply, there are several challenges that don’t get talked about as much, leaving parents frustrated or wondering if something is “wrong.”
As a pediatric speech-language pathologist, lactation consultant, craniosacral and oromyofacial practitioner, I’ve seen firsthand how these hidden hurdles can affect both babies and parents—and how small adjustments can make a big difference.
Oversupply and Fast Letdown
Some parents produce more milk than their baby can comfortably manage. A fast or forceful letdown can cause:
Choking, coughing, or gulping at the breast
Gassiness or spitting up
Preference for certain feeding positions
Babies may develop gulping patterns that are harder to break later, and parents can feel overwhelmed by engorgement or leaking. Adjusting feeding positions, pacing the feeding, or expressing a little milk before the feed can help regulate flow and make feeding more comfortable for both parent and baby.
Underactive Letdown or Milk Transfer Challenges
On the flip side, some babies struggle when milk flow is too slow. This can be related to subtle oral-motor differences, tongue ties, or a high palate, which make it harder for your baby to create suction. Signs include:
Frequent, inefficient sucking with little milk transfer
Fussiness or frustration at the breast
Long feeding sessions with slow weight gain
Early intervention can be key. Working with a pediatric SLP or oromyofacial therapist can help identify underlying oral-motor patterns and support more effective feeding through gentle exercises and positioning techniques.
Nipple Pain and Vasospasm
Persistent nipple pain, sometimes accompanied by blanching or color changes, is often dismissed as “normal soreness.” It can indicate:
Nipple vasospasm (blood vessel constriction)
Subtle latch or alignment issues
Addressing positioning, ensuring a proper latch, and sometimes using gentle warming or massage techniques can relieve pain and prevent further complications.
Jaw or Facial Fatigue in Babies
Babies can become tired during feeding, especially if their tongue, jaw, or facial muscles aren’t fully engaged. This may not always look dramatic—they may feed slowly or seem “lazy” at the breast. Early support can:
Reduce frustration for baby
Improve milk transfer
Support oral development
As a pediatric SLP and oromyofacial practitioner, I often guide parents in exercises and gentle craniosacral techniques that help babies engage their oral muscles without stress.
Subtle Feeding Behaviors
Sometimes the challenges are almost invisible: frequent breaks, slight seal loss, or mild fussiness. Parents may worry they are “doing something wrong,” but these behaviors can reflect:
Oral-motor inefficiency
Sensory sensitivities
Mild reflux patterns
Observing patterns over time and adjusting technique, support, and body alignment can make breastfeeding smoother and more enjoyable.
Body Tension and Posture: The Hidden Factor
Breastfeeding isn’t just about latch—it’s about how both parent and baby’s bodies work together. Tension in the neck, shoulders, jaw, or core can subtly affect feeding efficiency. For example:
Parent posture: Leaning forward or hunching can restrict milk flow, contribute to back or neck pain, and make long feeds exhausting.
Baby’s body alignment: Tight neck, jaw, or shoulder muscles can limit tongue movement and effective sucking.
Craniosacral rhythm: Gentle craniosacral techniques can help release tension in both parent and baby, allowing smoother feeding mechanics and a more comfortable experience.
By paying attention to posture, providing supportive positioning (pillows, nursing chairs, or side-lying holds), and using gentle techniques to release tension, feeding can become more efficient and comfortable for both parent and baby. This approach also supports long-term oral and musculoskeletal development.
Bottom Line
Breastfeeding is rarely perfectly smooth—but many challenges are manageable with the right support and a holistic approach. Understanding that difficulties often have a root cause—whether anatomical, sensory, or muscular—can turn frustration into confidence.
If you’re noticing unusual patterns, persistent pain, or slow milk transfer, reaching out to a skilled professional can make a huge difference. Small adjustments can create lasting improvements for both you and your baby.