How does tension in your baby's body affect feeding?

by Sabrina Granniss, IBCLC July 12, 2022

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 just happen when they are 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 repeated practice helps their brain learn the muscle patterns being used to feed.

How the baby uses their whole body to latch & breastfeed

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. Koala, side lying and laid back nursing use gravity to hold your baby on 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 are free to move their head forward and back 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 getting in the way of comfortable, effective and efficient breastfeeding.

Signs of tension in baby

Shallow latch or unable to open their mouth wide
Suck blisters
Clicking during nursing
Hungry soon after nursing
Torticollis
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
Breast refusal
Hiccups,sneezing or excess gas

Symptoms mom may experience

Pain when the baby is nursing
Low milk supply
Sore nipples
Vasospasms
Lipstick or misshapen nipple after baby unlatches
Creased nipple after feeding
Cracked or damaged nipples
Plugged ducts
mastitis

Causes of tension

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 births can manifest in tension in your baby’s body or injuries like fractures.
Interventions during delivery like 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 getting the series of compressions to their head and body as they rotate and come through the birth canal.
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 movement can cause tension on the body.
Oral restrictions create tightness and pulling of other areas of the body. The tongue is connected to the toes through the fascia system.(3)

Baby’s need to be able to move their head and neck comfortably for latching deeply and feeding. With the rooting reflex, they will turn their head side to side when the cheeks are touched. As your baby comes towards the breast, they tilt their head back and the chin presses into the breast which results in them opening their mouth. With their head slightly back, it is easier to open wide compared to if their neck has tension and is not comfortably able to tilt back. Their mouth will not open as wide and they may only slurp the nipple in and their latch will be more shallow.

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 do a full circle with your arm. The tension might affect the full range of motion of your arm or shoulder which is going to impact the rest of your body movements. If your baby has tightness and is not able to move certain 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 wide and flatter.(4) Over time, the effect can be seen with a narrow jawline, high palate, compromised airway development, sinus congestion and crowded teeth.(5)

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 the muscle patterns previously learned, practiced and strengthened.

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 so everything is fine yet still have symptoms that point in the direction of tension? How a latch looks or weight gain alone do 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.

Breastfeeding is mom and baby working together for comfortable and effective feeding. It should be enjoyable. When a baby has a hard time with nursing, you compensate, often unknowingly, to make feeding easier for your baby. These compensations can make the experience difficult, less enjoyable and interfere in bonding with the baby. An effective care plan will address all compensations.

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 helps each practitioner understand what the other is seeing and recommending. You and your baby will get better care and often see results faster.