Abstract
In this report, a mother presents at 29 days postpartum with extremely sore nipples. Her infant is 1 lb 2 oz (511 gins) below birth weight, a continuing weight loss consistent with failure to thrive. Failure to thrive may be caused by a variation in infant palatal structure (VIPS) such as a bubble palate. The mother demonstrated correct latch-on, positioning, and soreness secondary to nipple candidiasis concealing the VIPS as a hidden component to this breastfeeding problem. A thorough assessment of the infant at breast, the infant's oral anatomy and the mother's breasts revealed the VIPS and information necessary for treatment. Alternative positioning and repatterning of oral behavior resolved the breastfeeding problem. A variation in infant palatal structure may be a hidden breastfeeding problem and needs to be considered.
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