If you find that your baby is struggling at the breast and needs help, consider the following approaches.
1) Choose a supportive breastfeeding hold
These babies often do better in a laid-back, cradle, or side-lying hold. The cross-cradle hold may limit their need to come off of the breast periodically to deal with a large milk flow. The under-arm hold may result in more choking.
2) Allow the baby to direct the feed
Babies should be allowed to come on and off the breast as needed. Do not force them to stay on if they are choking or struggling to keep up with the milk flow.
Watch for signs that the baby is done feeding and do not force the baby to breastfeed longer than the baby wants to. A normal feeding pattern for a six-week old baby in this situation may be 10 minutes on one side every two hours.
Do not force the baby onto the second side if the baby is not showing hunger signs.
3) Be gentle
Babies may get frustrated when there is more milk than they can handle. Be gentle, let your baby direct the feeds, and reassure the baby with a soft, calming voice. Over time, the baby will learn to deal with the flow and the flow will slow down.
4) Pace the baby
Temporarily decreasing the amount of milk a baby takes in is called pacing the baby.
a) Temporary unlatching
If the baby is really struggling with a particular let-down, you can unlatch the baby so the baby can catch a breath.
To do this:
- Take the baby off the breast.
- Let the baby rest for 10 seconds or so until the let-down has passed.
- Re-latch when hunger signs appear.
Pacing in this way should only be done if the baby can latch easily.
b) Squeeze the breast
Pacing can be done by the mother using her fingers in a scissor or pinch position to squeeze the breast just in front of the baby’s mouth for a few seconds to slow the flow of milk during a strong let-down.
This should only be done if it does not interfere with the baby’s latch or cause breast or nipple pain. There is a small risk of this causing plugged ducts.
5) Deal with choking
If the baby chokes, just leave the baby in front of the breast and watch and wait. Normal babies can deal with choking without help. If the baby has a very bad choke, you can raise the baby onto your shoulder. Once the baby gives you a hunger sign, re-latch.
6) Help the baby with tummy pain
Babies whose mothers have a large milk supply will tend to have more tummy cramps during and after feeds. They may also swallow more air. Loud gulping can be a sign of this.
Such babies may benefit from regular use of the over-the-shoulder massage technique to both prevent and decrease the pain.