Breastfeeding and Bottle Feeding: Red Flags

Frequently Asked Questions (FAQs)

Having a newborn can be a time of anxiety. We spend 40 weeks learning and preparing for the arrival. We deliver the baby and are sent off on our own wondering what is next? Infant feeding is one of the greatest concerns of new parents. This FAQ will identify feeding red flags: when you should be concerned.

Difficulty latching

Obtaining a deep latch could be as simple as positioning changes. But when it is not, what could it mean? There are several reasons that a baby has difficulty latching and sustaining an effective latch. These could include a tongue or lip tie, oral sensory and oral motor difficulties. A baby that will latch on deep and then pulls into a shallow latch and keeps rooting around while having difficulty “finding” the nipple to latch on or gags' when trying to latch may have a oral sensory based problem. That means that the way that baby feels or processes sensory information is different and in this case it interferes with typical feeding. Weak latch, falling off the nipple or tongue clicks may indicated a oral motor based problem. An oral motor problem can mean that the tonged, lips, jaw, cheeks are not working correctly. Flattening or mischaping the nipple (like lipstick) can indicate that the baby has a tongue tie and/or an oral motor problem. Babies with latch problems can have difficulty stimulating let down, sustaining milk transfer, and/or obtaining hindmilk. Specialized feeding therapy can address oral sensory and/or motor difficulties and teach a baby how to produce an effective latch.

Feeding often takes an hour. Should I be concerned?

Yes. When feeding takes longer than 30-40 minutes, your baby may be working too hard and may burn more calories than they are taking in. When this happens, weight gain can be difficult. Slow feedings may also indicate feeding difficulties, which may lead to other complications if not resolved.

My baby is flattening or misshaping my nipples. Should I be concerned?

When you unlatch baby, your nipple should be elongated and maintain it’s round shape (if you have ever pumped, they should look like that). This means that baby used an effective sucking pattern. Flattened, misshaped nipples indicates that the tongue is not working correctly resulting in a poor suck pattern. The reasons for flattened or misshappened nipples may include oral sensory and/or oral motor dysfunction and tongue tie. This concern needs to be evaluated by a feeding specialist.

Should you wake a baby that falls asleep during feeding?

The answer to this question is based on many variables such as your baby’s weight gain and if your baby has any special diagnoses. When trying to figgure out the best answer, one must understand that waking a sleeping baby can burn a lot of calories if your baby is not wanting to wake up and continue feeding. Trying to feed a sleeping baby could accidently cause gagging or choking. Things become worrisome when the baby is not eating enough or gaining enough weight. Address any supply issues and ensure that the baby’s feeding patterns are efficient enough to take in appropriate volumes to enable weight gain. This is the first step. Understanding why the baby doesn’t finish is vital to identifying the solution. Some reasons may include dysfunctional oral sensory and motor patterns, poor sucking, fatigue, ineffective milk transfer. If you are concerned or need help identifying why your baby falls asleep and is not finishing feeding, consult a Feeding and Swallowing Specialist who can address these issues.