Difficulties with Breastfeeding: Newborn Physical Dysfunctions with the Latch

Breastfeeding is one of the best things a mother can do for herself and her newborn.  Newborn babies are designed to thrive exclusively on human breastmilk, which contains the perfect balance of nutrition for a growing baby, and changes with their needs.  Not only does it provide many health benefits for the mother, such as decreased chances of postpartum depression and breast and ovarian cancers, it also appears to promote proper brain development and reduce the risk of diabetes, leukemia, and asthma in newborns.  It has been shown that exclusively breastfeeding promotes ongoing milk production and helps strengthen the infant-maternal bond through its many hours of skin to skin contact.

The art and joy of breastfeeding may not come naturally to mother and child, especially when there has been a traumatic and difficult labor.  Sometimes even after resolution of tongue-tie, visits with lactation consultants for proper latching technique, and patency of mammary ducts, there are still difficulties. A new mother can become frustrated and discouraged, and give up altogether in an effort to feed their precious newborn.

The causes for difficulties with breastfeeding are complex and often multifaceted.  It can take anywhere from 6-8 weeks to establish normal feeding patterns and breastmilk supply. Many times the problem occurs with the infant’s inability to physically suckle or latch effectively. If the neurological programming that takes place with an improper latch is abnormal at this time, it may require patience and time to teach the baby how to suckle effectively.  Unnecessary delays in establishing successful breastfeeding can be avoided when normal function is restored to the infants muscles, joints and bones. Latching becomes easy and pleasurable for both infant and mother.

How can an abnormal position in-utero or a traumatic labor affect a newborn’s ability to latch?  Hard fast labors, long active labor with extended periods of pushing, and use of forceps/vacuum extraction can all cause trauma to the joints and muscles of the newborn baby’s head, jaw and neck. The temporomandibular joint, TMJ, is the joint where the lower jaw (the mandible) meets the skull.  Long labors with extended pushing as well as vacuum extraction and/or forceps can impede and/or compromise the motion of the TMJ.  This can effect the infants ability to open its mouth wide enough to take in the whole areola. The nerves that supply the muscles around the TMJ and tongue, which are necessary on the infant’s side for proper latching, run through the mandible.  Any interference with their function can the effect the strength of the latch. This can result ineffective latching, a baby slipping off the breast or the baby biting down on the areola.

How do you know if your baby has musculoskeletal dysfunction causing poor latching?  Common indicators for musculoskeletal dysfunction causing difficulty with breastfeeding are:

* painful latching; baby chews and damages mother’s nipples
* babies who cannot latch firmly and slip off
* inability to coordinate suckling, swallowing and breathing
* baby seems dissatisfied when nursing and pull on and off
* strong preference to nurse on one side over the other
* baby needs to suck all the time

What can a mother do to help her newborn?

1.  Gently massaging the inside of the infant’s mouth, following the top of the gums backward and along the outside of the jaw by the ear, can sometimes help relieve some tight muscles in and around the TMJ.  This will allow the mouth to be more relaxed and the infant to have an easier time opening its jaw.

2. Massaging the suboccipital muscles located at the base of the infant’s skull.  This will allow the baby an easier time with neck extension (putting the head backwards) which can also relax the jaw.

3. Cranial molding by the parent:  Author Justine Dobson’s book “Baby Beautiful: A Handbook of Baby Head-shaping” shows techniques on how to normalize the shape of your baby’s head, which can lead to better function of the muscles and bones, leading to more effective and comfortable latching for the baby

4. Treatment by a pediatric chiropractor, osteopath or craniosacral therapist. Sometimes misalignments with facial and cranial (skull) bones can cause problems with latching.  If your infants face and/or head are asymmetrical in appearance (different from left to right) having it worked on by a pediatrically trained manual therapist can relieve tension and abnormal joint biomechanics.  After the musculoskeletal dysfunction is resolved, the help of a lactation consultant or skilled nurse can help fine tune the nursing techniques.

There are lots of alternatives to conventional methods of breastfeeding. In my personal experience, I have seen babies with latching difficulties latch significantly better after just one treatment with a skilled pediatric manual therapist.  If you believe misalignment could be the issus, it is recommended to get the opinion of an expert to ensure you and baby’s breastfeeding experience is a comfortable and successful one.

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Dr. Kristina Bosnar
Dr. Kristina Bosnar is a chiropractor with a special focus on perinatal and pediatric care. Dr. Bosnar believes in an integrated and holistic approach to the perinatal period and pediatric care. Dr. Bosnar is passionate about supporting women physically and emotionally through the wonderful and unexpected challenges that can occur from the prenatal to the postpartum period.
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