The Latch Revolution

Why breastfeeding pain isn't always caused by the nipple.

"It feels like my baby's gums are biting me."

It's a phrase many mothers use.

There's no wound.

No crack.

No teeth.

Just deep bruising pain that doesn't seem to make sense.

In this final episode of the Stop Guessing Series, Johanna Sargeant IBCLC and Katie James IBCLC explore babies with tight jaws and feeding compensations, explaining why clamping is often a sign that a baby is solving another underlying problem.

Rather than treating the symptom alone, they discuss how recognising compensations can help uncover what's really happening beneath the surface.

• Why some babies clamp or "chomp" instead of suck

• The difference between bruising pain and nipple damage

• How babies compensate when normal sucking isn't working

• Why understanding compensation changes the way we support families

✓ The companion observation framework

✓ The complete Stop Guessing Series

✓ Clinical reflections

Think about a mother who described breastfeeding as feeling bruised, tight or like "teeth."

Could that pain have been telling you something about the baby's oral function rather than the latch alone?

The Latch Revolution creates practical education for healthcare professionals supporting babies with feeding difficulties.

We believe better observation leads to better questions, and better questions often lead to better support.

Why long feeds don't always mean babies are feeding well.

Some babies feed for an hour.

They click.

They lose suction.

They fall asleep.

Then they're hungry again.

It's easy to assume they're simply sleepy or "lazy."

But what if they're working incredibly hard just to maintain a feed?

In this third episode of the Stop Guessing Series, Johanna Sargeant IBCLC and Katie James IBCLC explore one of the most commonly overlooked feeding challenges—low vacuum.

Together they explain why understanding function, rather than simply watching the latch, can completely change the way we assess babies with sucking difficulties.

• What low vacuum looks and feels like during a feed

• Why clicking and losing suction matter

• How babies compensate when they cannot maintain an effective vacuum

• Why looking beyond milk transfer helps identify the real challenge

✓ The companion observation framework

✓ The complete Stop Guessing Series

✓ Clinical reflections

Think about a baby you've described as "sleepy" or "lazy" at the breast.

Could they have been working much harder than they appeared?

It Feels Like Teeth

The Latch Revolution creates practical education for healthcare professionals supporting babies with feeding difficulties.

We believe better observation leads to better questions, and better questions often lead to better support.

Some babies seem to struggle with everything.

The breast.

The bottle.

The dummy.

Even your finger.

Parents often describe a baby who gags easily, feeds for long periods, starts well but gradually begins to struggle, or suddenly plateaus in their weight gain.

In this second episode of the Stop Guessing Series, Johanna Sargeant IBCLC and Katie James IBCLC explore how a high palate and oral sensitivity can quietly affect feeding, and why these babies are often misunderstood.

Rather than focusing on the palate alone, they explain how to recognise the wider pattern of compensations and observations that help build a more complete clinical picture.

• Why a high palate is only one piece of the assessment

• The feeding behaviours that often point towards oral sensitivity

• How finger assessment can reveal valuable clinical information

• Why listening carefully to the mother's story is one of your most powerful assessment tools

✓ The companion observation framework

✓ The complete Stop Guessing Series

✓ Clinical reflections

Think about a baby who seemed to struggle with breastfeeding, bottle feeding and dummy use.

What clues might have suggested that oral sensitivity or a high palate was contributing to the bigger picture?

The Latch Revolution creates practical education for healthcare professionals supporting babies with feeding difficulties.

We believe better observation leads to better questions, and better questions often lead to better support.

When a baby is struggling to feed, it's tempting to look for a single explanation.

But what if feeding difficulties are rarely caused by just one thing?

In this first episode of our Stop Guessing Series, Johanna Sargeant IBCLC and I (Katie James IBCLC) introduce the clinical observation philosophy that underpins our work with babies experiencing sucking difficulties.

• Why isolated symptoms rarely tell the full story

• The five areas that guide every assessment

• Why curiosity is often more valuable than certainty

• How better observation leads to better support

✓ The companion observation framework

✓ The complete Stop Guessing Series

✓ Clinical reflections

Think about the last baby whose feeding "didn't quite make sense."

What observations might you revisit if you stepped back and looked at the whole picture?

About The Latch Revolution

The Latch Revolution creates practical education for healthcare professionals supporting babies with feeding difficulties.

We believe better observation leads to better questions, and better questions often lead to better support.

Season One may be over… but we’re only just getting started.

We’re taking a short summer break before returning in August with a special four-part mini-series unlike anything we’ve released before.

Together we’ll work through feeding case studies, taking you behind the scenes of our clinical reasoning. Rather than simply discussing symptoms or diagnoses, we’ll explore how experienced lactation consultants begin to ask better questions.

And perhaps most importantly… what are we missing when we focus on treating the symptom instead of understanding the cause?

If you’ve enjoyed the conversations throughout Season One, this series will take you one step further inside the decision-making process we use every day with the families we support.

If you’re a midwife, lactation consultant, speech pathologist, health visitor, doctor, paediatric clinician or anyone supporting breastfeeding families, we think you’re going to enjoy this one.

We’ll see you in August.

Until then…

Thank you for listening, sharing the podcast, leaving reviews and being part of The Latch Revolution.

Enjoying the podcast?

Leave us a 5-star review, subscribe so you don’t miss the new mini-series, and if you’d like to support the show, you can join us on Patreon.

Keywords

The Latch Revolution, oral function, infant feeding, breastfeeding education, IBCLC, lactation consultant, midwife education, breastfeeding support, feeding assessment, sucking difficulties, oral assessment, tongue function, bottle feeding, breast refusal, breastfeeding challenges, case studies, Decoding the Suck, breastfeeding professionals

Years ago, Katie stopped attending births for friends. The boundaries felt clear. But one simple conversation sparked an uncomfortable realisation: Why was she still providing lactation support for them?

In this honest and surprisingly personal episode, Katie and Joh explore the complicated space where friendship, professional expertise and breastfeeding support collide.

Episode Summary

As lactation consultants, midwives and birth professionals, many of us become the unofficial breastfeeding hotline for friends, family members and colleagues.

But what happens when those relationships become blurred?

In this episode, Katie and Joh unpack the emotional realities of supporting friends through breastfeeding challenges. They discuss the pressure of feeling responsible for outcomes, the difficulty of setting boundaries, and the unexpected emotions that can arise when friends seek support elsewhere or make different feeding decisions than we hoped.

Together they explore how their thinking has changed over the years, why some professional boundaries are easier to recognise than others, and how friendship can quietly become entangled with clinical responsibility.

Along the way they share personal stories, professional reflections and a few moments of humour that many birth professionals will recognise immediately.

In This Episode We Cover

Want More From Katie and Joh?

Check out our courses for professionals:

Decoding the Suck: Gentle support for babies with sucking difficulties

Breastfeeding & Lactation: The Fundamentals

Pregnant or a new mum? Find more support from Katie:

The Feeding Couch – Breastfeeding SOS – for new mums

Newsletter

Join our newsletter for evidence-based education, podcast updates and practical insights from Katie and Joh.

Instagram

Katie: @katiejameslactation

Johanna: @milkandmotherhood

We’d Love To Hear From You

Send us a message on Instagram or email us [email protected]  We’d genuinely love to hear your story.

Medical Disclaimer

Disclaimer: The content of this podcast is for educational and informational purposes only. It is not a substitute for personalised medical advice, diagnosis, or treatment. Listeners should always seek the guidance of their own healthcare provider, midwife, or lactation consultant with any questions they may have regarding their own situation or that of their clients. Katie James and Johanna Sargeant do not accept responsibility for any decisions made based on this content.

Keywords

lactation consultant boundaries, breastfeeding support, supporting friends, IBCLC, midwife boundaries, doula boundaries, professional boundaries in healthcare, friendship and professional relationships, breastfeeding professionals, lactation consultant burnout, postpartum support, reflective practice, client relationships, birth professional boundaries, breastfeeding counselling, maternal health professionals

When breastfeeding is causing significant pain or nipple trauma, should a mother keep feeding through it?

Or are there times when a temporary change in the feeding plan may actually protect breastfeeding long term?

In this episode, Katie and Joh explore one of the most challenging clinical decisions faced by lactation consultants, midwives and breastfeeding supporters.

Episode Summary

Breastfeeding professionals are often taught how to support mothers to continue breastfeeding. Sometimes harder is knowing when continuing exactly as things are may be contributing to ongoing pain, tissue damage, stress, and feeding difficulties.

In this episode, Katie and Joh discuss how they approach severe nipple pain and trauma in clinical practice. They explore the factors that influence decision-making, including wound healing, maternal wellbeing, feeding goals, pumping, nipple shields, and the importance of individualised care.

The conversation highlights the reality that many breastfeeding situations sit firmly in the grey zone. Rather than rigid rules, the discussion focuses on clinical reasoning, transparency, and working collaboratively with mothers to develop plans that feel achievable and supportive.

As always, this is an honest conversation between two experienced clinicians navigating the complexity of real-world breastfeeding support.

In This Episode We Cover

Want More From Katie and Joh?

Check out our courses for professionals:

Decoding the Suck: Gentle support for babies with sucking difficulties

Breastfeeding & Lactation: The Fundamentals

Pregnant or a new mum? Find more support from Katie:

The Feeding Couch® – Breastfeeding SOS – for new mums

Instagram

Katie: @katiejameslactation

Johanna: @milkandmotherhood

YouTube: The Latch Revolution

Enjoying the podcast?

Leave us a 5 star review - please scroll a bit further down and do it now! ;)

Support the show on Patreon:

Medical Disclaimer

The content of this podcast is for educational and informational purposes only. It is not a substitute for personalised medical advice, diagnosis, or treatment. Listeners should always seek the guidance of their own healthcare provider, midwife, or lactation consultant with any questions they may have regarding their own situation or that of their clients. Katie James and Johanna Sargeant do not accept responsibility for any decisions made based on this content.

Keywords

nipple trauma, nipple pain, breastfeeding pain, breastfeeding support, lactation consultant, IBCLC, breastfeeding complications, wound healing, pumping and breastfeeding, nipple shields, breastfeeding management, breastfeeding challenges, breastfeeding education, lactation support, midwife education, doula education, breastfeeding professional development, maternal wellbeing, clinical lactation skills, breastfeeding counselling

Bottle Preference vs “Nipple Confusion” | Flow, Breast Refusal & Paced Feeding

Last episode, we unpacked bottle refusal in breastfed babies.

This week, we’re tackling the other side of the feeding conversation:
what happens when babies begin preferring the bottle over the breast — or what many people still call “nipple confusion.”

Except… babies usually aren’t confused by nipples at all.

In this episode, lactation consultants Katie James and Johanna Sargeant explore what’s actually happening when babies begin refusing the breast after bottles are introduced — and why flow, sucking mechanics, oral function and feeding dynamics matter far more than most people realise.

We discuss:

• bottle preference vs “nipple confusion”  
• flow preference in breastfed babies  
• why some babies begin refusing the breast  
• how milk flow changes sucking behaviour  
• fast flow vs slow flow feeding dynamics  
• paced bottle feeding that genuinely mimics breastfeeding  
• how to bottle feed without sabotaging breastfeeding  
• bottle feeding positions and latch mechanics  
• non-nutritive sucking and letdowns  
• oral function signs that often get missed  
• late-onset low milk supply linked to feeding mechanics  
• teat shape, bottle flow and feeding behaviour  
• mixed feeding and combination feeding support  
• breastfeeding politics and fear-based messaging  
• how to support families without shame or black-and-white advice

This episode is for:
midwives, lactation consultants, IBCLCs, speech pathologists, maternal child health nurses, doulas, infant feeding professionals, and parents trying to navigate breastfeeding and bottles without panic, guilt or confusing advice.

One of the biggest themes in this episode is nuance.

Because bottles are not poison.  
Teats are not poison.  
And one bottle does not automatically ruin breastfeeding.

But feeding mechanics matter.

And the way we support families around bottle feeding matters too.

Mentioned in this episode:
• paced bottle feeding  
• flow preference  
• breast refusal  
• oral function assessment  
• bottle feeding mechanics  
• late-onset low milk supply  
• mixed feeding support  
• responsive feeding approaches

Listen to the previous episode:
Why Babies Refuse Bottles - And What Gets Missed

Support The Latch Revolution Podcast:
If these episodes help you, leaving a 5-star review genuinely helps more parents and professionals find the podcast.

You can also support the podcast and access extra content here with Patreon:

Connect with us:
Instagram:
@katiejamesibclc  
@milkandmotherhood

Courses & Education:

Katie James & Johanna Sargeant - Decoding the Suck training for professionals

The Latch Revolution - Exercises for parents to support their infants suck challenges

The Feeding Couch — breastfeeding education for parents:

Breastfeeding & Lactation: The Fundamentals — professional education for birth workers


Disclaimer:
This podcast is for education and information only and should not replace individual medical advice, diagnosis or treatment. Please seek support from your own healthcare provider, IBCLC, midwife or medical professional for individual concerns.

#breastfeeding #bottlefeeding #pacedfeeding #nippleconfusion #breastrefusal #lactationconsultant #IBCLC #oralfunction #mixedfeeding #newbornfeeding #breastfeedingpodcast #postpartum #midwife #speechpathology #infantfeeding

Bottle refusal isn’t always behavioural. 

And if you’ve tried every bottle on the market without success… there may be something else going on.

In this episode, Katie and Johanna, IBCLC's, unpack bottle and teat refusal in breastfed babies — looking at both the behavioural side as well as the physiological side that often gets missed.

They walk through the practical strategies many parents are already trying: changing positions, changing the caregiver, adjusting milk temperature, experimenting with teat flow and creating low-pressure experiences around bottles.

But they also explore why some babies still struggle despite all of that.

The conversation dives into oral function, tongue movement, high palates, gag reflexes, bottle teat design, and why some babies physically struggle to coordinate sucking on certain bottle shapes.

Katie and Johanna also discuss how stress and pressure around bottle feeding can quickly escalate into bottle aversion — and why play, curiosity and responsiveness matter far more than forcing feeds.

Importantly, we talk about the situations where bottles simply aren’t working before a return to work, many babies compensate by 'reverse cycle feeding' — breastfeeding much more frequently overnight.

This episode is packed with practical ideas, nuanced clinical discussion, and reassurance for both mums, new parents and professionals.

Why breastfed babies may suddenly refuse bottles

Behavioural strategies that genuinely help

Why teat shape matters more than marketing suggests

Bottle flow rates and matching milk flow

The role of milk taste

Why some babies become distressed around bottles

High palates, tongue tie and oral sensitivity

The connection between bottle refusal and sucking function

Why play and curiosity reduce bottle aversion

Open cups vs straw cups vs bottles

Reverse cycling and feeding when mums return to work

Why observation matters more than rigid rules

Decoding the Suck — Professional Training

NEW Parent Sucking Support Packages

Susan Howard IBCLC - Reel with O Ball and bottle teat

The Feeding Couch® — Breastfeeding Support for Parents

Breastfeeding and Lactation: the fundamentals - Professional Training

If you enjoy The Latch Revolution podcast:

Leave a 5-star review! 

Subscribe 

Share the episode 

Support the podcast on Patreon:

The content of this podcast is for educational and informational purposes only and should not replace individual medical care. Mums and new parents should always seek support from their own healthcare provider, lactation consultant or medical practitioner regarding their individual circumstances.

bottle refusal breastfeeding, breastfed baby won’t take bottle, teat refusal baby, high palate bottle refusal, tongue tie bottle refusal, oral function breastfeeding, paced bottle feeding, reverse cycling breastfeeding, bottle aversion breastfed baby, breastfeeding and bottle refusal, lactation consultant bottle refusal

Mastitis isn’t just an infection. And the way we’ve been treating it… might be making things worse.

In this episode, Katie and Joh unpack mastitis through a more current lens — moving away from the idea of “blocked ducts” and towards understanding inflammation as the key driver.

They explore the early signs many women miss — including the flu-like symptoms that can appear before any visible breast changes — and why recognising these early can change the entire trajectory of the condition.

The conversation also challenges long-standing advice around heat, massage, and increased feeding, explaining why these approaches may worsen inflammation rather than resolve it. Instead, they introduce a more physiologically aligned approach focused on rest, anti-inflammatories, cold therapy, and maintaining normal feeding patterns.

Importantly, they discuss what happens when mastitis doesn’t fully resolve — including subclinical presentations, changes in milk supply, and the impact on baby behaviour. The episode also highlights the emotional and practical realities for mothers navigating mastitis, and the need for clinicians to remain flexible, transparent, and responsive when protocols don’t fit the individual.

In This Episode We Cover

Want More From Katie and Joh?
Check out our courses for professionals:
Decoding the Suck: Gentle support for babies with sucking difficulties

Breastfeeding & Lactation: The Fundamentals

Pregnant or a new mum or parent? Find more support from Katie:
The Feeding Couch® – Breastfeeding SOS – for new mums and parents

Instagram
Katie: @katiejameslactation
Johanna: @milkandmotherhood

YouTube
The Latch Revolution

Enjoying the podcast?
Leave us a 5 star review
Subscribe so you don’t miss future episodes
Support the podcast via Patreon:

Medical Disclaimer
Disclaimer: The content of this podcast is for educational and informational purposes only. It is not a substitute for personalised medical advice, diagnosis, or treatment. Listeners should always seek the guidance of their own healthcare provider, midwife, or lactation consultant with any questions they may have regarding their own situation or that of their clients. Katie James and Johanna Sargeant do not accept responsibility for any decisions made based on this content.

Keywords
mastitis breastfeeding, mastitis inflammation vs infection, blocked ducts myth, mastitis treatment cold therapy, lactation mastitis protocol, breastfeeding pain inflammation, milk supply mastitis, baby refusing breast mastitis, subclinical mastitis, lactation consultant education