41: Feeding Red Flags- 6 Signs to Seek Help Now
It is no secret that I am an advocate for utilizing the support available to us when it comes to feeding newborns. I will say however, that finding the right support is important. Many self proclaimed “feeding specialists” have strong black or white opinions on how you “should” feed your baby or address problems.
To me, mothers and babies are a bit more nuanced than that. That’s why I don’t recommend a cookie cutter feeding schedule with strict times. Instead, I encourage you to understand infant cues and their general developmental expectations. That way, you have a foundation of knowledge with which to build your plan from and you can recognize red flags early.
Today we are going to touch on some of those red flags. Six signs that indicate your baby is working harder than expected and something is off.
Please know that while many feeding concerns have a simple solution, others can be tricky, because one sign (or symptom) can be caused by one or more underlying issues.
Take some of the classic signs of tongue tie for example: clicking sounds while feeding, painful shallow latch, and fussiness after feeds. Sure those can all be caused by a structural issue impeding the baby’s tongue mobility and their success with transferring milk at the breast. But…they can also be signs of reflux, swallowing discoordination, and reduced tongue mobility due to non-structural issues.
So keep in mind as we go through our list of 6 feeding red flags, that the underlying cause is not always what it seems, but when you are able to identify issues early, it helps you to resolve the problem sooner and avoid snowball issues.
Now six signs that there is a feeding concern and it’s time to seek help:
If your newborn baby is taking too long or not nursing long enough. Cluster feeding is considered normal, but when your baby is taking an hour to feed or only feeding for less than 5 minutes most of the time- this isn’t expected. One way to look into this concern is by seeing out an International Board Certified Lactation Consultant (IBCLC) and getting a weighted feed done on their special scale. Then you’ll have an idea of how effectively your baby is nursing and learn how to support them so they aren’t working too hard to get their needs met. This includes newborn babies who just aren’t feeding at least 8 times a day, or who are constantly feeding around the clock with no breaks. When a baby is working too hard at the bottle to get their needs met, a speech language pathologist (SLP) who specializes in infant feeding may be the right support person.
If you have a “noisy” feeder, which includes the following: gulping, hard swallowing, congestion or wetness with feeding, coughing, choking, sputtering, wheezing, rattled or labored breathing, clicking, slurping, popping, or any other funky sounds while they are eating; then a SLP or lactation consultant (or both) may be part of your team.
If a baby has very strong positional preferences, like only nursing on one side or only taking a bottle with a funky neck position, this can impact how effectively and safely they feed. When I see this, I want to know why. There are multiple providers who might be helpful. A pediatric SLP, IBCLC, physical therapist (PT), occupational therapist (OT), Allergist, or gastroenterologist (GI) doctor depending on the underlying issue.
If your breastfed baby is not gaining enough weight, or gaining weight too quickly, then a lactation consultant should be called in. If this is the case for your already bottle fed baby, then a SLP (again one who specialized in infant feeding) can be very helpful. In these cases, your pediatrician may also have ideas on who to call or what’s going on. If they aren’t sure, or are offering Bandaid fixes- then go ahead and request the support you think you need.
Sleep feeding is not a normal crutch. It can happen for a myriad of underlying reasons. Sometimes when a baby consistently refuses the breast or is constantly unsettled while awake, the family falls into this pattern of feeding them while they are half asleep. Only getting your baby to eat when they are sleeping or worn down, is a red flag. It’s one thing for your baby to get drowsy as they nurse or at the end of their feed when their belly fills with milk and they go into rest and digest mode. But it’s an entirely different thing if you can only get your baby to eat while they are sleeping or they never rouse. Not to mention, forcing a bottle when a baby is asleep, or pretending to be asleep because they are shut down, has both safety and mealtime relationship consequences. This can be caused by multiple issues, and an SLP can help you to determine if there is a swallowing coordination issue at play. Remember, that babies do want to eat when they are hungry. So if they are shutting down, they are telling us something. (If you have a baby that is very lethargic or dehydrated, turn this podcast off and get emergency help right away.)
Lastly, if you have any nipple pain, breast pain, pumping issues please get a lactation evaluation with an IBCLC (International Board Certified Lactation Consultant) to help figure out the underlying cause and get things back on track. The longer you wait, the more unnecessary pain and the longer it may take to resolve.
So there you have it, six signs to seek help now.
Remember, if you have a concern or want more information about a feeding issue, it’s important to find the right support people for you, and that sometimes it takes a little digging to find them. This is especially important when you are faced with a concern. That’s why I recommend knowing who you are going to call before you give birth if possible. It’s not because they will be able to fix any unforeseen issues that arise every time. It’s because your first step to support will be there if you need it, and it makes it so much easier to reach out if you do need help.