Medical problems can affect the baby's growth in three main ways:
1) A medical problem that interferes with breastfeeding
Some babies cannot breastfeed effectively because of a medical problem such as a cleft palate. Other causes include:
- A blockage of the nasal passages (choanal atresia)
- A blockage of the airway (laryngomalacia, paralysis of the vocal cords)
- A very short jaw bone (retrognathia)
- A fluid-filled sac (cyst) in the tongue
These babies generally show clear signs of being underfed unless supplemented with milk. They will gain quickly when they are supplemented. The supplementing tool will need to be appropriate for the baby’s problem.
2) A medical problem that prevents the baby from keeping in milk
Babies who cannot keep in enough milk usually have obvious signs such as vomiting or very large amounts of spitting. They may have a blockage or other abnormality of the throat, swallowing tube (esophagus), stomach, or bowels. These babies often need urgent attention and even surgery (Wiechers 2020).
They generally show clear signs of being underfed such as being thin or having poor weight gain but milk supplements do not usually improve their growth significantly.
3) A medical problem that prevents the baby from growing well
Babies who have a less obvious problem may gain very slowly but seem well otherwise.
a) Examples of medical problems that can result in poor growth
We have seen babies with the following problems being misdiagnosed as having breastfeeding problems:
b) Characteristics of babies with medical problems that result in poor growth
These babies are generally content, may not look particularly thin, and do not gain faster with milk supplements and may even refuse them. They gain slowly and are short.
These babies may:
- Have lips that turn blue during breastfeeding.
- Breathe hard while feeding.
- Not have much energy.
- Have frequent infections.
- Refuse milk supplements.
They may show abnormalities when examined by a health-care provider and require additional tests such as blood, X-ray, ultrasound, scoping, and genetic analysis to find out what is wrong.