When the Pain Doesn't Match the Story You Were Told
You were told breastfeeding might hurt for the first two weeks. You were told the pain would ease once your baby 'figured it out.' You've adjusted the football hold. You've cracked open another tube of lanolin. And the pain is still there. So is the shallow latch. So is the baby who slips off the breast every few minutes.
At Latched Beginnings in Austin, this is the story we hear almost every day. Painful breastfeeding and a shallow latch are signals worth taking seriously, especially when they persist past the early weeks. They aren't always caused by a tongue-tie. But they often are.
This article walks through what's actually going on, what to try before assuming the worst, and when an in-person tongue-tie evaluation makes sense.
What 'Painful Breastfeeding' Actually Looks Like
There's a difference between the first-week tenderness most moms experience and the kind of pain that means something else is going on. The pain we want you to take seriously is:
Pain That Doesn't Improve Past Two Weeks
The initial discomfort of breastfeeding usually peaks in the first 7 to 10 days and starts to ease. If you're past two weeks and still wincing through every latch, that's a flag. Persistent pain is not the price of nursing.
Lipstick-Shaped or Cracked Nipples
When your nipple comes out of your baby's mouth shaped like a tube of lipstick or with a white compression line across it, your baby is compressing the nipple rather than drawing milk efficiently. Cracks, blisters, and bleeding are signs of friction from a poor latch.
Pain That Continues Between Feeds
Vasospasm, throbbing pain, or burning that lasts beyond the feed itself can indicate nerve compression or persistent damage from compromised latching.
Plugged Ducts, Mastitis, or Low Supply
When your baby doesn't drain the breast effectively, milk gets stuck and supply drops. Repeated plugged ducts and mastitis are body-level signs that the latch isn't working.
What a Shallow Latch Looks Like (and Why It Happens)
A deep latch means your baby's mouth is wide open, with most of the areola in their mouth, lips flanged out, and chin pressed against the breast. A shallow latch is the opposite: lips curled in, only the nipple between the gums, cheeks dimpling with each suck.
Shallow latch happens for a few reasons. Sometimes it's a positioning issue. Sometimes it's nipple shape or breast tissue. And sometimes, often, it's because your baby's tongue can't lift, extend, or cup deeply enough to draw the breast in. That tongue restriction is what we evaluate at Latched Beginnings.
When to Suspect a Tongue-Tie
Painful breastfeeding and a shallow latch in isolation don't always mean a tongue-tie. But when they appear with two or three of the patterns below, the chance of an oral restriction rises significantly.
Your Baby Clicks or Loses Suction Often
A clicking sound means the tongue isn't staying lifted to maintain a seal. Babies with restricted tongues often break suction repeatedly during a feed.
Long, Inefficient Feeds
If feeds are taking 45 to 60 minutes and your baby is still hungry an hour later, milk transfer is likely inefficient. That points to mechanical issues, not just hunger cues.
Excessive Gas, Reflux, or Spit-Up
When the seal breaks, babies swallow air. That air becomes gas, fussiness, and reflux-like symptoms. Many of the babies we see in Austin were on reflux medication before anyone evaluated the tongue.
Visible Heart-Shaped Tongue or Limited Tongue Mobility
A heart-shaped or notched tongue tip when your baby cries, or a tongue that can't lift toward the roof of the mouth, is a structural sign.
What to Try Before Assuming a Tongue-Tie
We always recommend trying functional support first when feeding issues are mild and your baby is gaining well. Many Austin moms find improvement through:
Working with an International Board Certified Lactation Consultant (IBCLC) who can troubleshoot positioning, latch mechanics, and milk supply.
Bodywork from a pediatric chiropractor, cranial-sacral therapist, or infant massage practitioner. Babies with body tension often have tighter latches.
Adjusting positioning. The laid-back or 'natural breastfeeding' position lets gravity do some of the work and often gives babies a deeper latch.
If pain persists despite these supports, that's the signal to bring in an oral tie evaluation. You're not jumping to conclusions. You're being thorough.
The Whole-Baby Approach to Feeding Pain
At Latched Beginnings, we don't separate the structural side of feeding (the anatomy) from the functional side (the latch, the milk transfer, the comfort). They're the same picture. Dr. Kacie Culotta, DDS is a laser-certified dentist and a lactation counselor, which means she can evaluate both during a single visit.
We also work closely with lactation consultants and bodyworkers across Austin. If your baby needs bodywork before a release, we'll coordinate. If your baby needs ongoing lactation support after, we'll connect you. The goal isn't a procedure. The goal is a baby who feeds well and a mom who isn't in pain.
How Latched Beginnings Helps Moms in Pain
If you've been told breastfeeding pain is normal and your gut is telling you otherwise, you're not crazy. You're paying attention.
We see hundreds of Austin families a year with this exact story. Painful latches. Cracked nipples. Babies who can't transfer milk. The relief on a mom's face when someone finally watches her feed, examines her baby thoroughly, and explains what's happening is the reason this practice exists. Dr. Culotta has lived this herself. Our all-mom team has too.
You don't need a referral. You don't need to have it all figured out. You just need to feel like something is off, and trust that instinct enough to schedule the evaluation.
Frequently Asked Questions
Is painful breastfeeding always caused by a tongue-tie?
No. Painful breastfeeding can be caused by positioning, nipple shape, vasospasm, thrush, or a mismatch in flow and demand. A tongue-tie is one common cause, especially when the pain persists past two weeks despite lactation support. A proper evaluation looks at all possibilities, not just one.
How can I tell if my baby has a shallow latch?
A shallow latch usually shows lips curled inward, cheeks dimpling, only the nipple between the gums, frequent slipping off the breast, and clicking sounds. A deep latch has lips flanged out, mouth wide open, chin pressed to the breast, and quiet rhythmic swallowing. Most lactation consultants can identify this within seconds.
Should I see a lactation consultant or a dentist for latch pain?
Start with a lactation consultant if positioning and basic latch mechanics haven't been ruled out. If pain persists and a tongue-tie is suspected, see a provider who's trained in both feeding and oral anatomy. Latched Beginnings sees many families who've already worked with an IBCLC and need the structural piece evaluated.
How long should I try fixing latch issues before considering a tongue-tie evaluation?
If you've been working with a lactation consultant for 2 to 3 weeks and pain is still significant, an oral tie evaluation is reasonable. You don't need to wait months. Earlier evaluation tends to mean easier recovery and less pain endured unnecessarily.
What is a posterior tongue-tie and why is it often missed?
A posterior tongue-tie is a restriction further back under the tongue, often hidden beneath the floor of the mouth. It doesn't always show the obvious heart-shape and is commonly missed during routine newborn checks. Up to 30% of the second-opinion consults we see at Latched Beginnings turn out to involve a posterior tie.
Can a shallow latch in a newborn lead to mom's low milk supply?
Yes. When a baby can't transfer milk efficiently, the breast doesn't get the signal to keep producing. Over a few weeks, this can drop supply. Repeated plugged ducts, slow weight gain, and falling pumping output are common signs that latch inefficiency is affecting supply.
Does fixing a tongue-tie really make breastfeeding easier?
For the right baby, yes. Many Austin moms report immediate improvement in latch depth, less pain within days, and full functional change over 2 to 6 weeks. For babies whose feeding issues are not driven by oral restriction, however, a release won't help. That's why a thorough evaluation matters.
Where can I get an evaluation for breastfeeding pain in Austin?
Latched Beginnings at 1701 Simond Ave, Suite 107A in Austin offers in-person evaluations led by Dr. Kacie Culotta, DDS. She holds both a laser certification and a lactation counselor certification. We see families from Mueller, East Austin, Round Rock, Cedar Park, Pflugerville, Leander, and Georgetown.
Call to Action
If you've been wondering whether your baby might have a tongue-tie, you don't have to figure it out alone. Dr. Kacie Culotta and the all-mom team at Latched Beginnings are here to listen, evaluate, and walk you through what's actually going on with your baby. Schedule a 1-on-1 consultation in Austin and let's talk through it together. Trust your instincts. We'll take it from there.
