When you think of breastfeeding, do you automatically think only about your baby’s latch? Breastfeeding is so much more than just the latch. In fact, breastfeeding is a whole-body activity. If your baby has tension in their body, it can affect positioning and latching. Your baby may have tension for various reasons, and investigating where the tension is and how it impacts breastfeeding can help determine what might help eliminate the tension that is interfering with your breastfeeding relationship.
How the baby uses their whole body to latch & breastfeed
After birth, when your baby is placed on your belly with their head in the middle of your chest, they use their reflexes to navigate toward your breast, find the nipple and begin to feed. These reflexes happen automatically and not by choice. Breathing and blinking are other examples of automatic, involuntary reflex responses. We do not need to think about them; they are expressed when signaled.
In the breast crawl, babies use many reflexes to move themselves up toward the chest. The Montgomery glands on the areola secrete a fluid that smells like amniotic fluid helping the baby to find their way. As they get closer, they turn their head side to side, rooting for the nipple. They lift their head and then come forward to latch. When their chin presses into the breast, they open their mouth wide and come over the nipple and begin to suck. Be patient and allow your baby time to go through each step. The breast crawl should be practiced many, many times in the first weeks of life. This repetition helps their brain learn the muscle patterns being used to feed.
How to improve latching & positioning
A position that allows them to feel stable makes using their reflexes easier. They can focus on nursing rather than where their body is in space.
Consider the direction gravity is pulling their body. Straddle, side-lying and laid-back nursing use gravity to hold your baby to your body and give the baby more control during feeding. Other positions like cradle, cross cradle and football hold need you to take more of a role to hold onto and support the baby more because gravity is pulling the baby away from your body.
Position your baby belly-to-belly with lots of contact with your body. Your baby’s ear, shoulder and hip should all be in a straight line.
Babies use their hands to support their neck and shoulders while feeding. Keep their hands free to be able to massage and shape or mold the breast tissue.
Avoid holding the back of their head. Neck extension can only happen if they have the freedom to move their head forward and back, unrestricted and with ease.
With their head tilted slightly back, the lower jaw comes forward. This makes opening their mouth wide easier for a deeper latch and comfortable swallowing.
If they are unable to use each muscle as intended for feeding, they will figure out alternatives to get the task of feeding done. Those compensations can cause other symptoms and may hinder comfortable, effective and efficient breastfeeding.
Signs of tension in baby
Shallow latch or unable to open their mouth wide
Clicking during nursing
Hungry soon after nursing
Their body seems rigid or stiff
Lays in a C-shape or banana curve position
Leaks milk during bottle feeding
Only wants to nurse on one side or in one position
Clamping or biting
Irregular or infrequent stooling
Hiccups, sneezing or excess gas
Symptoms mom may experience
Pain when the baby is nursing
Low milk supply
Lipstick or misshapen nipple after baby unlatches
Creased nipple after feeding
Cracked or damaged nipples
Causes of tension
A baby’s position in utero can cause strain or tension in a muscle. It’s like when you sleep all night in a funny position and wake up with a crick in your neck.
Birth - both very fast and slow deliveries can manifest in tension in your baby’s body or injuries like bruising or fractures.
Interventions during delivery, including forceps or a vacuum, put pressure on the baby’s skull. This pressure can push on nerves affecting the messaging from the brain to different muscles.
Cesarean birth skips over your baby descending and experiencing a series of compressions to their head and body as they rotate and come through the birth canal. Those compressions are sometimes compared to a baby’s first chiropractic adjustment.
Swaddling restricts your baby’s movements. Babies have spontaneous movements at random, which later become sequential. (6) Through movement, their brain is able to map muscles and how they work together. This impacts other areas of growth and development and feeding. Restriction of movement can cause muscles to become tight in the body.
Oral restrictions create tightness that may radiate to other areas of the body. The tongue is connected to the toes through the fascia system. Your baby must be able to move their head and neck comfortably to latch deeply and feed effectively and efficiently. With the rooting reflex, they turn their head side to side when their cheeks are touched. As your baby approaches the breast, they tilt their head back, and the chin presses into the breast, resulting in them opening their mouth. With their head extended slightly back, it is easier to open their mouth wide, compared with when their neck has tension, making it less comfortable or able to nod forward and back. Their mouth can not open as wide, and they are more likely to slurp in the nipple, resulting in a more shallow latch.
Tension anywhere in the body decreases the range of motion a muscle will have. For example, if you have a sore or tight neck, you may not be able to rotate your arm or shoulder in a full circular motion. The tension might affect the quality or limit the range of motion of your arm or shoulder, impacting the rest of your body movements. If your baby has tightness and cannot move certain body parts easily, it also affects their ability to comfortably latch and breastfeed.
The muscles direct the growth of the bones in the face and jaw. (1) If the baby has a shallow latch or is not able to lift their tongue to press breast tissue into the roof of the mouth, the bones are instructed to grow tall and narrow rather than broad and flatter. (4) Over time, some of the effects may be a narrow jawline, high palate, compromised airway development, sinus congestion and crowded teeth. (5)
What to do if you suspect your baby has tension?
Were you told your baby’s latch looks fine or that they are gaining weight and, therefore, everything is fine, yet you or your baby still have symptoms pointing in the direction of tension? How a latch looks or weight gain alone does not give a complete picture of your baby’s ability to use their mouth and body in a functional way.
An IBCLC (International Board Certified Lactation Consultant) who has obtained the skills for assessing your baby’s reflexes, body tension and oral function can help you investigate further. They can identify what is causing the symptoms you see for yourself and in your baby and create a plan with you for targeting and resolving them.
Bodywork is often part of the solution for eliminating tension in the baby. (2) Your IBCLC will be able to give you the names of providers who have experience working with babies and have had positive outcomes. Providers who communicate with each other help each practitioner understand what the other is seeing and recommending. You and your baby will get better care and often see results faster.
How easy or hard it is for your baby to feed at the breast can be great information for how to improve their latch and feeding skills. By addressing latching, tension and other challenges, you also give your baby a solid foundation from which the rest of their growth and development build from. Each developmental milestone relies on previously learned, practiced and strengthened muscle patterns. Breastfeeding involves mom and baby working together for comfortable and effective feeding. It should be enjoyable. When a baby has a hard time with nursing, you often compensate unknowingly to make feeding easier for your baby. These compensations can make the experience challenging, less enjoyable and interfere in bonding with the baby. An effective care plan created with your IBCLC should address all compensations and help you and your baby towards successful breastfeeding.