THE LEARNING OUTCOMES:
Painful nipples and low milk supply are among the most common causes of early breastfeeding cessation. According to Righard (1998), 94% of nipple problems are related to ineffective positioning or attachment, rather than gaps in clinical guidance. As midwives, we must take responsibility for identifying and addressing these underlying causes. This interactive workshop takes a deeper look at the mother–baby dyad, recognizing the entire dynamic between mother and infant. By observing how the baby latches, suckles, and swallows, we gain critical insight into the origin of breastfeeding problems. Participants will sharpen their clinical observation and reasoning skills to translate visual cues into effective care. Recognize the multifactorial causes of nipple trauma. Learn to interpret nipple appearance as a reflection of breastfeeding mechanics. Observe and analyze the mother–baby dyad to identify feeding dysfunctions. Develop practical skills to assess positioning, attachment, and infant suck. Enhance treatment plans by linking visual signs to functional causes.

THE PROCESS/ACTIVITIES:
After a short introduction, participants will work in small groups (4–6 midwives) on realistic postpartum cases. Each group will work around a clinical case with images and videos. Groups will discuss the causes, observe short videos of the mother–baby dyad, and propose an individualized treatment plan. Cases and strategies will be discussed in plenary.

AUDIENCE PARTICIPATION:
Active group work with clinical reasoning, visual cases, video observation, and shared discussion across cultural and clinical contexts. Learning from each other's experiences and local protocols is encouraged. Additional reading Riordan J. Breastfeeding and Human Lactation. 5th ed. Jones & Bartlett Learning; 2015. Dennis CL, et al. Interventions for treating painful nipples among breastfeeding women. Cochrane Database Syst Rev. 2014;CD007366. Righard L. Are breastfeeding problems related to incorrect breastfeeding technique and the use of pacifiers and bottles? Birth. 1998. Spencer J. Common problems of breastfeeding and weaning. UpToDate. Accessed May 31, 2026. Tommelein C, Muyldermans R. Borstvoeding: een praktische gids voor de zorgverlener. Academia Press; 2019.