International Board of Certified Lactation Consultant (IBCLC) Practice Exam

What common birth-related factor could lead to nipple pain during nursing?

1. Breast engorgement

2. Inverted nipples

3. Tongue tie

4. Fungal infection

The correct answer is: Tongue tie

Tongue tie, medically known as ankyloglossia, is a condition where the band of tissue connecting the tongue to the floor of the mouth is shorter than usual, which can restrict tongue movement. This limited mobility can create challenges during breastfeeding. For a baby to latch effectively, they need to be able to extend their tongue sufficiently to grasp the nipple and areola properly. When a baby with tongue tie tries to breastfeed, they may not achieve a good latch. This poor latch can cause friction and pressure on the nipple, leading to pain and discomfort for the nursing parent. In contrast, while breast engorgement, inverted nipples, and fungal infections can also be associated with nipple pain, they relate to different mechanisms. For instance, breast engorgement leads to swollen and hard breasts, which can make it difficult for a baby to latch, but the pain arises primarily from the pressure rather than the latching issue itself. Inverted nipples might complicate latching but are a structural issue rather than a functional one that can cause pain directly. Fungal infections can cause irritation but are often tied to secondary factors rather than the mechanics of breastfeeding itself. Thus, tongue tie is the factor directly impacting the latch and resulting in nipple pain during nursing