This may seem very obvious, but many times I have seen babies breastfeed
in a way that brings in a lot of air. Often the mother has complained of
a colicky baby when I notice this little lip dance. That is when baby is
bringing the lips towards the gums and pushing back away during nursing.
There doesn't have to be any cheek sucking in and out, the lips are
enough to make the suck inefficeint and increase air intake. Mom may not
even have sore nipples from this. It is a refinement of a working latch
- that is less than optimal.

Explaining to the mom that the object-of-the-game is to get so much
breast in the mouth that there is a small rotation of the jaw in an
upward/inward circular motion, but no other visible movement (no lip
moving, no breast going back and forth in/out of the mouth ever so
slightly) helps tremendously. Then the lips remain stable on the breast
and there is a decreased amount of breast back-and-forth motion, also.
In fact seeing the breast remain steady during the feed may totally
eliminate the colic.

I remember one infant that had caused much dispair to her parents. The
doctor was ready to do some sort of test(?). The mom stopped at WIC just
for vouchers, I didn't even see the baby but told her
the-object-of-the-game plan. It worked for her, as it has for others,
and the PNP at the MDs office was very surprised.

But then latch is usually the underlying problem for lots of things.

Paula Bermingham, IBCLC
WIC BF coordinator
Lake County CA (CEMR-WIC)