Logo - The Possums baby and toddler sleep program.
parents home
librarybrowse all programsfind answers nowaudioprograms in audiogroup sessionsgroup sessions with dr pam
menu icon NDC Institute
possums for professionals
(the ndc institute)
menu icon eventsguest speakers
menu icon the sciencethe science behind possums/ndcmenu icon who we arewho we aremenu icon evidence basendc research publicationsmenu icon dr pam's booksdr pam's books
menu icon free resourcesfree resourcesmenu icon dr pam's blogdr pam's blog
menu icon consult with dr pamconsult with dr pammenu icon consult with dr pamfind a possums clinicmenu icon find a NDC accredited practitionerfind an ndc accredited practitioner
login-iconlogin

Welcome back!

Forgot password
get access
search

Search programs

PBL Intermediate icon

PBL Intermediate


  • Comparing a stable vs an unstable position in breastfeeding
  • Notice where your nipple falls when baby comes off the breast
  • When baby's nose buries into the breast and airflow is obstructed
  • Is baby's suck too weak or too strong?
  • Let's work out what might be going wrong in these videos
  • Let's work out what might be going wrong in these photos
  • Why skin-to-skin contact in the bath is unlikely to help breastfeeding problems and might make things worse

Next article

Sign up now
  • PBL Intermediate
  • S4: Getting fit and hold right for you and your baby
  • CH 3: Using the gestalt method to trouble shoot problems
  • PT 3.1: Things to notice about fit and hold during breastfeeds

Is baby's suck too weak or too strong?

Dr Pamela Douglas13th of Jul 202418th of Dec 2025

x

Are you concerned that your baby's suck might be too weak?

There's no evidence to suggest that the musculature of some babies mouths or their suck is innately 'weak' or less competent (as long as baby isn't born prematurely, and doesn't have a diagnosed medical condition like cleft palate or a neurological disorder).

When oral vacuums or pressures are measured in breastfeeding babies, researchers have found a wide range of normal variation in oral vacuums during breastfeeding in babies who were born at term (that is, not born prematurely), and who aren't causing their mothers nipple pain. Some babies have a peak vacuum that is twice that of other babies, all of whom are breastfeeding normally.

In well term babies, it's not the muscular effort of the suck, but the presence or absence of breast tissue drag inside baby's mouth which determines how effective a baby's suck is.

You can find out more about how babies suck here, and about the tongue and its movements here.

Are you concerned that your baby's suck might be too strong?

Sometimes women tell me they are worried that their baby's suck is too strong, and that it is causing them pain.

It is true that researchers have found that the babies of breastfeeding women with nipple pain have peak oral vacuums that are higher than the normal range.

However, sucking is contextual. If that baby is experiencing nipple and breast tissue drag, he'll be reflexly generating higher vacuums to try to hold the breast tissue and draw it into his mouth better. In my view, the higher peak vacuums linked with nipple pain is due to the (unidentified and untreated) nipple and breast tissue drag.

Selected references

Geddes DT, Kent JC, Mitoulas LR, Hartmann PE. Tongue movement and intra-oral vacuum in breastfeeding infants. Early Hum Dev. 2008;84(7):471-477. doi:10.1016/j.earlhumdev.2007.12.008

McClellan HI, Geddes DT, Kent JC, Garbin CP, Mitoulas LR, Hartmann PE. Infants of mothers with persistent nipple pain exert strong sucking vacuums. Acta Paediatrica. 2008;97(9):1205-1209.

Finished

share this article

Next up in Things to notice about fit and hold during breastfeeds

Let's work out what might be going wrong in these videos

x

The gestalt method of fit and hold is only one part of the Neuroprotective Developmental Care (NDC) or Possums breastfeeding programs (under development as Breastfeeding stripped bare), but an important place to start. This version of the gestalt method of fit and hold for breastfeeding women has been available since 2016. I'm hoping that Breastfeeding stripped bare, the comprehensive NDC approach to breastfeeding and lactation, will be publicly available by the end of 2024. Key elements of the NDC breastfeeding work are also found in The discontented little baby book, and in my research publications, starting here.

Video 1

This woman…

Keep reading
logo‑possums

Possums in your inbox

Evidence-based insights, tips, and tools. Occasional updates.

For parents

parents homebrowse all programsfind answers nowprograms in audiogroup sessions with dr pam

For professionals

possums for professionals
(the ndc institute)
guest speakers

About

the science behind possums/ndcwho we arendc research publicationsdr pam’s books

More resources

free resourcesdr pam’s blog

Clinical consultation

consult with dr pamfind a possums clinicfind an ndc accredited practitioner

Help & support

contact usfaqour social enterpriseprivacy policyterms & conditions

Social

instagramlinked infacebook

Possums acknowledges the traditional owners of the lands upon which The Possums Programs have been created, the Yuggera and Turrbal Peoples. We acknowledge that First Nations have breastfed, slept with, and lovingly raised their children on Australian lands for at least 65,000 years, to become the oldest continuous living culture on Earth. Possums stands with the Uluru Statement from the Heart.