Breastfeeding challenges are one of the most common concerns I see in newborns — and in many cases, it’s not something the parent is doing wrong. 

When nursing feels painful, frustrating, or just doesn’t seem to “click,” there is often an underlying issue affecting how the baby feeds. Identifying those issues early can make a meaningful difference for both baby and parent. 

Why Breastfeeding Can Feel Painful or Inefficient 

One feeding pattern we sometimes see in newborns is called reverse peristalsis. Instead of the tongue moving rhythmically to help draw milk in and create suction, the tongue moves outward — essentially pushing milk away rather than pulling it in. 

When this happens, nursing can feel: 

• Pinchy or painful 

• Inefficient, with poor milk transfer 

• Frustrating for both baby and parent 

Parents often describe sessions where their baby nurses briefly, becomes fussy, or seems unsatisfied after feeds. 

Signs Your Baby May Be Struggling to Transfer Milk 

When babies have difficulty feeding effectively, we often see clues such as: 

• Pain during breastfeeding 

• Clicking or popping sounds while nursing 

• Fussiness or frustration at the breast 

• Very short feeds (nursing for a minute or two and stopping) 

• Poor weight gain or slow growth 

These signs are not uncommon — and they deserve thoughtful evaluation, not dismissal. 

How We Approach Breastfeeding Concerns at Canopy Pediatrics 

At Canopy Pediatrics, breastfeeding concerns are never brushed off as “normal” without proper assessment. 

As a pediatrician, board-certified lactation consultant, and breastfeeding medicine physician, I don’t just ask questions — I perform a comprehensive evaluation to understand why feeding may be difficult. 

What a Breastfeeding Assessment Includes 

A thorough assessment may involve looking closely at: 

The baby’s mouth and anatomy 

• Tongue appearance and movement 

• Palate shape 

• Upper lip tie 

• Lower tongue tie 

Maternal anatomy 

• Nipple shape (flat or inverted nipples can affect latch) 

Suck mechanics 

• Is the tongue moving in the correct direction? 

• Is the baby creating suction or simply opening and closing their mouth? 

Baby’s body alignment 

• Neck tightness (such as torticollis) 

• Overall body tension or asymmetry 

Feeding is a full-body activity, and small issues can have a big impact on comfort and effectiveness. 

Why Early Assessment Matters 

When feeding difficulties aren’t addressed early, they can lead to: 

• Nipple damage 

• Mastitis 

• Ongoing pain with nursing 

• Poor milk transfer and inadequate weight gain 

The good news is that many of these complications are preventable with early, careful assessment and support. 

Treatment Options Are Individualized 

Depending on what we find, support may include: 

• Adjustments to breastfeeding positions or holds 

• Referrals to specialists when needed 
• Bodywork or physical therapy 
• Evaluation and treatment of tongue or lip ties.

There is no one-size-fits-all solution — and that’s exactly why individualized care matters. 

Our Goal at Canopy Pediatrics 

Our goal is simple: 

A calm, happy, well-feeding baby — and a confident, supported parent. 

If you’re pregnant, newly postpartum, or breastfeeding and something doesn’t feel right, a thorough evaluation can make a world of difference. You don’t have to struggle through this alone. 

Support exists — and sometimes, the right assessment is all it takes to change the experience.