A breastfed baby must be able to remove milk from the breast well. He / she has to get enough milk to gain weight and provide proper nutrition. A baby’s sucking also “tells” the breasts to increase or maintain milk production. Poor milk removal can cause problems with weight gain and nutrition because the baby is not getting enough milk. Poor milk removal will cause a decrease in mom’s milk supply.
There are many things that affect how well a baby can suck and remove milk from the breast. Some babies have problems staying awake. Other babies have problems coordinating suck, swallow and breathe patterns. A few babies have conditions that affect the structure of the mouth which makes feeding difficult. Some causes of suck or latch-on problems include:
- Prematurity
- Labor and delivery medication
- Down syndrome
- Jaundice
- Infection
- Cardiac defects
- Tongue-tie
- Cleft lip or palate
It is important to know the signs that a baby is not removing milk from the breast well. Steps can be taken to correct the problem. There are signs of ineffective sucking in the baby who:
- Does not wake on his / her own for feedings eight or more times in 24 hours
- Latches on and then lets go of the breast often during the feeding
- Falls asleep within five minutes of latch-on or after sucking two or three minutes
- Does not suck regularly for the first seven to ten minutes of a feeding
- Feeds for more than 30 minutes without acting full
- Produces less than two stools in 24 hours by the end of the first week (for the first four to eight weeks)
- Produces fewer than six soaking wet diapers in 24 hours by the end of the first week
The mother who:
- Has persistent sore or bruised nipples or areola
- Develops red, raw or cracked nipples
- Has creased or flattened nipples after feedings
- Does not have breast fullness before feedings and does not have softened breasts after feedings
- Has more than one episode of plugged ducts or mastitis
