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

Dr Pamela Douglas14th of Jul 20244th of Dec 2025

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Your baby will commonly receive misdiagnoses when there are (undetected) fit and hold problems

We have a serious health system blind spot about fit and hold problems, which are often inappropriately diagnosed as medical conditions or infant suck dysfunctions. Here are the various diagnoses babies might be given when they're actually showing signs of an unstable position and breast tissue drag in breastfeeding.

  • Cranial nerve, neurological or motor dysfunctions (wrongly said to cause impaired tongue movement and poor suck)

  • Allergy

  • Reflux

  • Gut pain or dysbiosis

  • Air swallowing

  • Lactose intolerance

  • Oral connective tissue restriction.

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.

You are also likely to receive misdiagnoses when there are (undetected) fit and hold problems

Here are some other diagnoses that you might be given if you are experiencing nipple and breast tissue drag during breastfeeding, resulting in nipple pain or damage.

  • Nipple thrush

  • Subacute mastitis

  • Neural sensitisation or neuropathic pain

  • Idiopathic vasospasm

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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