Baby's Not Latching? Decoding the Mysteries of a Fussy Feeder

Feeding is one of the earliest and most important interactions between a newborn and their caregiver. When a baby struggles to latch or appears fussy during feeds, it can quickly lead to stress, frustration, and feelings of inadequacy for the parent, especially the mother. While breastfeeding is natural, it doesn’t always come naturally. Understanding the reasons behind a baby’s poor latch or fussy feeding behavior can empower parents and improve outcomes for both mother and child.

Latching refers to the way a baby attaches to the breast to feed. A proper latch allows the baby to efficiently extract milk, promotes adequate weight gain, and prevents nipple pain or damage for the mother. According to the American Academy of Pediatrics and the World Health Organization, exclusive breastfeeding for the first 6 months offers optimal health benefits. However, if a baby is not latching well, it can result in insufficient milk transfer, poor weight gain, prolonged feeding times, and even early weaning.

A poor latch is often a key reason behind fussy feeding, and addressing it early is crucial to avoid a cascade of feeding difficulties.

A baby who is not latching effectively may exhibit the following signs:

These signs warrant a closer look at both the baby's oral anatomy and feeding technique.

Tongue-tie (Ankyloglossia):

One of the most cited anatomical causes of poor latch is tongue-tie, a condition in which the lingual frenulum restricts the tongue’s range of motion. A 2017 study in Pediatrics found that 4–10% of newborns may have a tongue-tie, which can interfere with latching and milk transfer. Symptoms may include clicking noises, maternal nipple pain, and short feeding sessions.

Prematurity or Low Muscle Tone:

Preterm infants or those with hypotonia (e.g., Down syndrome or neurologic conditions) may not have the coordination or stamina to latch effectively.

Cleft Lip or Palate:

Structural differences in the oral cavity can make it physically difficult for a baby to create suction.

Oral Thrush or Reflux:

Oral thrush can cause pain during feeding, while gastroesophageal reflux may lead to discomfort that disrupts feeding behavior.

Flat or Inverted Nipples:

These can make latching more difficult for the baby. While many infants eventually adapt, some may need additional support, such as using nipple shields temporarily.

Oversupply or Forceful Let-Down:

If milk is flowing too fast, the baby may struggle to manage the flow, resulting in coughing, gagging, and pulling off the breast.

Nipple Pain or Engorgement:

Maternal discomfort or anxiety during feeding can interfere with let-down reflexes, further complicating the baby’s ability to latch.

Incorrect positioning is one of the most common and modifiable causes of a poor latch. Cradle, cross-cradle, football, and side-lying positions all have different advantages. Ensuring the baby’s mouth is wide open, the chin is touching the breast, and the nose is free can significantly improve latch quality.

Not all fussiness at the breast is pathological. Growth spurts, overstimulation, or cluster feeding periods (typically around 2–3 weeks, 6 weeks, and 3 months) can make babies appear fussier than usual. However, persistent refusal to feed or crying during feeds requires medical evaluation.

If a latching issue is not identified and corrected, it can lead to:

If the baby is not latching by the second or third day of life or is showing signs of dehydration, such as sunken fontanelles or decreased urination, seek medical advice urgently. A lactation consultant (IBCLC-certified), pediatrician, or breastfeeding counselor can assess both baby and mother and guide treatment.

In some cases, procedures like frenotomy (clip for tongue-tie) or oral motor therapy may be needed. Breastfeeding support groups can also provide peer encouragement and practical advice.

Breastfeeding difficulties can have a profound emotional toll on mothers. Feelings of guilt, failure, or inadequacy are common. It’s crucial to remind caregivers that feeding success is not measured only by exclusive breastfeeding but by the health and well-being of both baby and parent.

A 2020 review in Maternal & Child Nutrition emphasized the importance of non-judgmental, supportive care that respects maternal choice, whether breastfeeding, expressing milk, or using formula.

Fussy feeding and poor latching are common but manageable challenges in early infancy. Understanding the medical, anatomical, and behavioral factors that contribute to these issues allows for timely and effective intervention. With the right support, most babies and mothers can go on to have a fulfilling feeding journey.