My Baby Won't Latch or Has a Painful Latch - What Do I Do?

Signs of a good latch, how to identify what's going wrong, tongue tie assessment in Singapore, and where to get professional help.

Signs of a Good Latch

A good latch does not hurt (after the initial 10-15 seconds of latching on). It should feel like strong pulling or drawing, not pinching, biting, or burning. Here is what a good latch looks and feels like:

What you see

- Baby's mouth is wide open - not just the lips, but jaw dropped
- Both lips are flanged outward (not tucked in)
- Chin is pressed against the breast
- Baby's nose is clear or just touching the breast
- More areola visible above than below baby's mouth (asymmetric latch)

What you feel and hear

- Strong drawing or pulling sensation - not sharp pain
- Rhythmic sucking: suck-suck-suck-swallow pattern
- Audible soft swallowing (not clicking)
- Discomfort fades after first few sucks
- Nipple comes out round, not pointed or creased

Warning signs of a poor latch

- Nipple pain throughout the feed (not just initial 10-15 seconds)
- Nipple comes out lipstick-shaped, angled, or with a white line (vasospasm)
- Clicking or smacking sounds during feeding
- Baby keeps slipping off and re-latching
- Blistered, cracked, or bleeding nipples after more than a few days

Common Latch Issues and Their Causes

Problem	Common Cause	First Steps
Shallow latch	Baby not opening wide enough; positioning	Wait for very wide mouth before latching; try biological nurturing (laid-back) position
Clicking during feeds	Tongue tie, oversupply causing fast letdown, or poor seal	See an IBCLC for assessment - clicking often indicates restricted tongue movement
Pain throughout feed	Shallow latch, tongue tie, thrush, vasospasm	Unlatch and try again; if persistent, see IBCLC or GP
Baby refusing breast	Bottle preference after early supplementation, fast/slow letdown, tongue tie	Try laid-back nursing; skin-to-skin before feeds; avoid bottles if possible
Engorgement making latch hard	Milk coming in, missed feeds	Hand express or pump briefly to soften areola before latching

Tongue Tie in Singapore

Tongue tie (ankyloglossia) is a condition where the frenulum - the tissue connecting the underside of the tongue to the floor of the mouth - is too short or too tight, restricting tongue movement. It is present in approximately 4-11% of newborns. Not all tongue ties need treatment - only those that are causing functional problems with feeding.

Assessment and treatment in Singapore

KKH Lactation Service: Can assess for tongue tie and refer for frenotomy within the hospital system. Subsidised rates apply for B2/C ward patients. Expect waiting times.
Private IBCLCs: Most experienced IBCLCs in Singapore are trained to assess tongue tie severity and can refer to the appropriate provider for release. Cost: S$150-300 per session.
Frenotomy providers: Several ENT specialists and paediatric dentists in Singapore perform frenotomy (tongue tie release). Some use laser, some scissors. Cost typically S$300-700 in private settings; public hospital rates are lower.

Not every baby with a tongue tie needs a frenotomy. An assessment by an experienced IBCLC or paediatrician - ideally with a feeding observation - will clarify whether the tie is functionally significant. A frenotomy without skilled breastfeeding support often does not resolve the problem because latch habits also need to change.

Getting Professional Help in Singapore

If you are experiencing persistent pain, a baby who is not gaining weight, or frustration with feeding, professional support is worthwhile. Many latch problems are fixable with skilled guidance.

Provider	What They Offer	Approximate Cost
KKH Lactation Service	Full IBCLC consultation, feeding observation, weighted feed	S$30-80 subsidised; higher if private
NUH Lactation Clinic	Similar to KKH; best for NUH patients	S$30-80 subsidised
Private IBCLC (home visit)	2-hour home visit, feeding observation, written plan	S$150-300 per session
Polyclinic nurse / GP	Basic support, weight check, referral	S$8-20 subsidised