Breast Feeding Problems

by Dr. Christopher Chang, last modified on 4/13/21
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There are numerous maternal as well as infant factors that may lead to problems with breast feeding. Given this is an ENT office, maternal factors will be ignored and attention mainly focused on infant factors that may lead to breast feeding issues.

Breast feeding should be a painless and wonderful experience with benefits for both mother and infant. And for that to happen, a good latch is necessary.

In order for a good latch to occur, essentially 2 factors should be present:

• Good seal between lips and breast
• Flexible mobile tongue to suck and swallow the milk expressed from the nipple (watch video below)

If any of these factors are absent, feeding difficulties will occur.

Good Seal

A good seal helps the baby draw the nipple deeply into the mouth and assists in the suck in order to swallow the milk produced by the breast. When a good seal is absent, excessive amount of air is introduced into the infant's mouth which is also swallowed along with the milk. Furthermore, lack of a good seal makes it more difficult for the infant to keep the nipple drawn deeply into the mouth.

A good seal may be absent most commonly due to an upper lip tie. An upper lip tie is when there is a flap of tissue that tethers the upper lip to the gumline preventing the upper lip from flaring properly to seal against the breast.

More rarely, a cleft lip or palate can cause a similar problem.

Flexible Mobile Tongue

Assuming a good seal, the nipple is drawn deeply into the infant's mouth and the tongue actively "massages" the nipple to express the milk which is than swallowed.

However, if a tongue tie is present, the tongue tip is tethered to the floor of the mouth making it more difficult for the infant to draw the nipple into the mouth. Also, the infant may tend to chew the nipple with the gums.

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