Choking While Breastfeeding

By Jasna Cameron

Nursing your baby is the most intimate bonding experience between mother and child. Your baby is cradled in your arms, safe and secure. You can feel her little mouth on your breast while the liquid gold flows from your body into hers, giving her life, strength, and health, helping her grow while she drifts off into peaceful sleep. But you may be one of those unfortunate moms who has had the experience of sheer terror amid your infant’s coughing, choking, sputtering, and gasping for air with milk streaming out of her nose!

As frightening as it sounds, it is not unusual for a baby to choke on breastmilk. It often occurs because the hyper-gag reflex that protects babies from asphyxiation has been stimulated. This article intends to help mothers understand why babies choke and what they can do if it happens.

Why Does My Baby Choke?

Like an adult who chokes on their food, a baby can also experience the milk spilling into the airways and blocking essential airflow. Choking often occurs when the baby has more milk in its mouth than it can swallow; there are several reasons this may happen. It is sometimes due to an anatomical or functional disorder, but more often, nursing babies choke when the mother produces too much milk or uses an incorrect feeding position.

When the mother has an oversupply of breast milk, too much milk sprays into the baby's mouth, and they cannot swallow it quickly enough. Signs that you may have a problem with oversupply include coughing, choking, or restlessness at the breast. Babies may also gulp and choke due to the forceful ejection of milk with an overactive letdown. An overactive letdown is when your milk comes in too quickly when your baby starts suckling.

What Should I Do If My Baby Starts Choking While Feeding?

Often it is enough to stop breastfeeding and hold your baby in an upright position to give her time to manage the choking on her own. Support her head and neck and gently pat her back if necessary. The choking may go on longer, so you may need to administer first aid.

First aid involves lying your baby down on their stomach over your knees with their head supported and pointing downwards. Swiftly prod with your free hand between the shoulder blades moving upwards and applying five rapid, but gentle thrusts. You can also gently pat your baby on her back until she stops coughing and you are sure her airway is clear.

Should there be no improvement, please proceed to the nearest emergency room for more professional help.

How To Prevent Choking While Breastfeeding

Now that you understand what causes choking, you can take steps to prevent it.

If the problem lies with an oversupply of milk, you can try expressing a few minutes before the feed to reduce the flow that enters the baby's mouth while she is nursing.

If you are dealing with the forceful letdown, which happens when there is an accumulation of too much milk in the breasts, you can try a few things in preparation for and during the feed. If you feed on both breasts when you are nursing, apply pressure to the free breast, pushing your nipple down towards your ribs so your body knows not to send milk to that breast. It will slow down the flow.

You can also try feeding on one breast per feed, where a baby is fed on one side only for a few hours of feeds. Not only will the baby benefit from the hindmilk, which is rich in fat, but it will help reduce the overproduction of milk in the breast, which is not being used for that time.

Ensure the baby is latched on properly during the feed, as this can often make a world of difference. Babies who latch on properly can manage the flow of milk in their mouth straight into their throat, reducing the chances of choking. Conversely, improper latching can lead to the accumulation of milk in the baby's mouth, which often leads to choking.

Another easy trick that may prove helpful is to pull the baby off your breast every few seconds to allow her to slow down and breathe.

However, the most effective, easiest, and most practical method to implement is to change the feeding position while nursing. The goal is to make gravity work in your favor, substituting the traditional downward feeding positions with an uphill one that forces the milk to work against gravity. You can try a laid-back position, placing the infant a little higher than your breast so that the amount of milk entering her mouth can be regulated. Some moms report that lying on the side helps, as the baby can easily move away from the nipple and let the excess milk drip down the side of her mouth. A"down under" position has also been recommended, where the mother lies on her back with the baby on top, tummies touching.

Conclusion

Choking while nursing is a common problem for most babies. Even though they usually have an armory of natural self-protecting instincts and mechanisms to their advantage, sometimes moms have to lend a helping hand or administer gentle first aid to help the airflow. Find a feeding position that suits you best and allows you to use gravity to your advantage. Try a few prepping techniques on yourself to slow down or reduce the overproduction of milk.