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Fit and hold problems are commonly misdiagnosed in breastfeeding women and their babies

Dr Pamela Douglas14th of Jul 202425th of Dec 2024

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Misdiagnoses are commonly applied when your baby has an unstable position or there's nipple and breast tissue drag

We have a serious health system blind spot about fit and hold problems, which are often inappropriately diagnosed as medical conditions. You can find out about this in the Recommended Resources listed below.

Here are the inappropriate diagnoses babies often receive when they're showing signs of an unstable position and breast tissue drag in breastfeeding.

You might like to click on the link to find out about each diagnosis, including when it is and isn't relevant, or you can wait until you come to the chapter in Possums Breastfeeding & Lactation which deals with misdiagnoses in babies with fit and hold problems.

  • Allergy

  • Reflux

  • Gut pain or dysbiosis

  • Air swallowing

  • Lactose intolerance

  • Oral connective tissue restriction

  • Cranial nerve, neurological or sensory motor dysfunctions.

However, we don't want to miss a true medical condition in your baby. If you have concerns about your baby's weight gain or health, please see your local GP.

Misdiagnoses are also commonly applied when you have nipple pain or damage from breast tissue drag

Here are diagnoses that women often receive when they're experiencing nipple and breast tissue drag during breastfeeding. Click on the link to find out about each diagnosis, and when it is and isn't relevant, or just keep working your way through Possums Breastfeeding & Lactation.

  • Nipple thrush

  • Subacute mastitis

  • Neural sensitisation or allodynia

  • Idiopathic vasospasm

  • Oral connective tissue restriction in your baby

Again, we don't want to miss a true medical condition. If you have concerns about your own or your baby's health, please see your local GP.

Recommended resources

Lactating women experience high levels of nipple pain and damage because of our health system blind spot about fit and hold

All breastfeeding support professionals agree that fit and hold problems are the most common cause of nipple pain so why isn't every woman shown how to prevent it or how to do a quick early repair?.

Why are breastfeeding women and their babies often unnecessarily pathologised?

Overmedicalisation in the times of catastrophic environmental crisis

What drives overdiagnosis and overtreatment of restricted oral connective tissues in breastfeeding babies

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Next up in why does fit and hold matter so much?

The three key elements of stable fit and hold for enjoyable breastfeeding

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Your baby needs to be in a stable position so that you can eliminate nipple and breast tissue drag

Nipple and breast tissue drag (which I refer to as breast tissue drag for short) is the most commonly missed cause of breastfeeding problems. Breast tissue drag can result in

  1. Nipple pain and damage, and

  2. Baby dialling up at the breast.

These two problems often result in a cascade of other breastfeeding problems, for example, poor weight gain, breast inflammation or mastitis, and conditioned dialling up at the breast.

We need your baby in a stable position against your body before we can properly eliminate breast tissue drag. When your baby is positionally stable, she is relaxed and comfortable, with good spinal alignment, which means that there is no twisting of her little body.

  • You can find out about positional stability

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