How To Correct Clicking Noise While Breastfeeding

My baby is clicking or gagging. Is it Fast letdown? Is it crowd? Tongue Necktie?

You lot've got through the starting time couple of weeks of breastfeeding and but every bit y'all start to feel information technology'southward going ok, your baby has started gagging and choking while feeding or perchance she is latching off and on and getting her face sprayed with milk. Perchance during feeds you are hearing a clicking sound. Your baby also suddenly seems very gassy and upset. You asked your HV who suggested information technology could be reflux. A friend suggested it was a natural language necktie. Yous asked "Dr Google" who popped upwardly lots of links on Fast or Forceful Letdown / Oversupply and gives a solution of Cake Feeding. This is a mutual scenario and a large proportion of mums and babies take this experience to some extent. Do they actually all have reflux/colic/tongue tie? Do all these mums take oversupply? Could information technology be that over again, nosotros are just not understanding the big picture?

Is a Click a Click?

I want to first off past talking nigh the idea of a click.  I think that 10 years ago I didn't hear a lot of conversation about clicky feeds, but with the advent of social media, and online groups the sensation of "clicks" has massively grown, and many websites seem to exclusively link it to tongue tie.  It's virtually like a diagnosis of tongue necktie - "oh your baby clicks when feeding - it's probably a tongue necktie".  Just is a "click" the same from baby to babe?  Babies have all sorts of lilliputian noises that they make when feeding.  If yous are reading a website which only talks nearly clicks - yous are quite likely to interpret the sound you are hearing as a click likewise.

Would it surprise you to know that I've had more than a few consults for "clicks" just when I got in that location, the sound they were concerned most was actually a swallow sound.  In fact in a couple of cases the mum was unlatching the babe and repositioning each time she heard the "click" (a swallow) - which was leading to a really fussy, frustrated infant and incredibly long feeds.

A eat obviously happens at the back of the throat, information technology'southward a sound of the tongue at the back of the throat so it makes a guttural type audio which tin can absolutely have a "yard" sound to it.  It might sound a bit like "kuh kuh kuh "  or a "one thousand" audio "guh guh guh " or even a "ck ck ck" audio.  It's understandable that you might read about clicking and misinterpret a eat.

In fact "click" is probably not the best description of the sound that I think of as more than indicative of a natural language issue.  It has been described as many sounds over the years.   I've seen a  18th century text describing it every bit a "chucking noise".  I actually think this is more descriptive of the sound which can exist a trouble.  Kuh sounds are ordinarily good.  Wet sounding chucks or smacks are more of an issue.  I've added a link to a youtube video with a baby making these sounds at the lesser of the page.  You'll hear it's much more of a wet sound that what you think of equally a "click".

Why do we get this audio?  Well it'southward essentially a loss of seal.  When feeding a infant needs to extend and cup their natural language around the breast.  They seal their tongue around it and so move their natural language in a moving ridge to "milk" the breast.  The chuck/shuck /slurp type sound happens when the seal breaks.  Yous tin make it yourself by placing your natural language firmly against your palate and then pulling it down sharply.  You will detect that it makes very dissimilar sounds depending on where you lot are placing most pressure with your tongue.  Pressing up through the eye of your tongue volition cause a dissimilar sound to pressure mostly through the sides of your tongue, and this is why we can get a diverseness of sounds with feeding.

Why does a baby lose the seal at all though?

Is information technology fast letdown?  It can be -  but actually the letdown is supposed to be pretty fast.  Having a fast letdown isn't something you ever demand to fix - we tin can look at ways to help the infant cope amend.  That may exist as elementary as positioning.

Is information technology oversupply.  Possibly -  but in my experience many more people worry about oversupply than actually take it.  Weight gain is the diagnostic cistron here - if your baby is gaining 1lb a week or more and then yes, you are looking at oversupply.  More on that below.

Is it tongue tie - possibly.  Natural language tie absolutely stops the tongue from moving as it should and can certainly cause frequent seal breaks, but so tin can positioning issues, engorgement, issues caused by a difficult birth, immaturity.  It's certainly not diagnostic of a tongue tie!  Only a tongue tie cess will tell yous whether a babe has a tongue brake - and that involves much more than than listening to a feed.  Information technology volition involve a trained professional person using a gloved finger to assess specific tongue movements.

Could there be another cause - Absolutely!  Lots of other possible causes - keep reading.

What about a baby gagging?  Is that fast letdown/crowd/tongue tie?

Babies have a very circuitous suck-swallow-breathe coordination procedure requiring a large number of nerves and muscles working together. The wave like motility we discussed above allows a baby to most continuously breathe while sucking. The basic process is as follows: Milk is transferred from the breast into the infant's mouth. Infant then takes a jiff while moving the milk to the back of her throat in preparation for a swallow. As the milk reaches the back of her pharynx expanse she does a short exhale and and so holds her breath while she swallows. After the swallow is complete she exhales the residual of the held breath. Information technology is a very complex and intricately timed process. When a baby is gagging /choking or spluttering at the chest information technology is generally considering the smooth coordination of the suck-consume-exhale rhythm has been disrupted and the consume and exhale is mis-timed. As adults we still occasionally have mis-timed swallows, and we might talk near a potable having gone "downwardly the wrong style". We can put downwards the drinking glass and recover, but for babies the milk continues to flow. That leads to difficulty keeping up with menstruum (choking/spluttering).

Why clicking /gagging now?

Many mums and babies detect this happening around iii weeks. A big office of the reason for the timing is the change in milk supply. Milk volume changes rapidly in the beginning couple of weeks. In the offset few days of colostrum a mum is producing perchance a teaspoon or two of milk at a feed, averaging about xxx-45ml over the course of 24 hrs. When her milk "comes in" there is a rapid modify to big volumes of milk building over the first 2 weeks. By the time a mum gets to around 14 days she may be producing 800ml of milk over the form of a mean solar day. It is an enormous change. With the volume the letdown is a bit faster, but a fast letdown and oversupply are entirely different things. Fast milk at letdown is normal! Information technology is normal and expected that milk volition begin to spray and it makes complete sense when we remember about what is happening within the breasts. Inside the breasts milk is stored in brawl like structures chosen alveoli which are surrounded past muscle fibres. At letdown the muscles contract and literally squeeze the milk into the ducts and down through the nipples. A crude analogy would exist to think of a bath toy which sprays of h2o when you clasp it. This is what happens at letdown and is normal. A baby should be able to handle this ideally, but lots of things can impact on the suck-swallow-breathe coordination meaning that some babies may mistime swallows (gagging).  Some babies may try to cope by breaking the seal and re-engaging over again (chucking/smacking racket).  A baby struggling with the flow does not necessarily hateful that mum has a faster than normal letdown or that she has crowd. It tin can mean that mum has a completely normal letdown and normal supply simply that her baby is struggling with the normal menstruum.

Why would baby have bug coordinating the catamenia / maintaining a seal?

In that location can be lots of different reasons why this might happen with a normal supply. It may simply be due to immaturity. The suck-swallow-breathe coordination matures at different rates and completely mature coordination may only develop at 42 weeks gestation for some babies, or even in the weeks following birth for other babies. Gestation lengths of babies varies enormously, and that means what we recall of as a 2 week erstwhile infant can vary enormously. A baby born at 42 weeks for example may have 5 weeks further development than a baby who was built-in at 37 weeks, even though they are both considered full term babies. Those weeks tin can have a big effect on a baby'due south coordination. Given that equally adults information technology still happens the states from time to time, it shouldn't be surprising that an immature newborn would have this feel.

Information technology could be due to the zipper. A baby who isn't well latched to the chest won't have as good coordination of milk transfer and may splutter at the breast.  This might be a simple positioning set up.  It might be that the chest is really full and house and the baby just can't go latched on deeply.  It might be that the breast is big and heavy and the babe is having difficulty belongings the chest in their mouth.  It may be that y'all lifted your breast when latching on, then permit go and this is causing the breast to move in baby's mouth making information technology hard for them to maintain a deep latch.

It might simply be that babies are slightly "behind" the milk volume.  When babies are born, they take done some rudimentary practising of sucking and swallowing of amniotic fluid, but that fluid is not travelling under pressure level.  The baby just has to open their mouth, fluid will enter, so tin swallow.  When they are built-in, colostrum flows pretty slowly.  And then suddenly milk volume increases and they need to play "grab up".  The tongue is a muscle.  The jaws are moved past muscles.  Imagine having muscles that you just used gently for as long equally you had those muscles and then suddenly you have to use them pretty vigourously for v hours a solar day.  The more the milk book increases, the faster that milk flows and the more than/faster your tongue has to work.  Letdowns have extremely fast flow, between letdowns it's slower flow.  If you were doing this with your legs you lot'd probably call it Fartlet training or HIIT training.  Muscles get tired.  Sometimes they just can't keep upward in the outset few weeks of training.  They go stronger and a few weeks later the same activeness isn't an consequence.

It could be something that happened at nativity. A baby's skull undergoes meaning moulding at birth in gild to permit information technology travel through the birth culvert. Remember of the shape of a newborn's caput immediately after birth and how information technology changes over the first few days and weeks. Add in the impact of any medical interventions on the skull shape. Forceps, vaccum birth or cesarean section can cause different moulding to a infant's head. Whatever moulding of the bones affects the muscles which are attached to those bones - including the muscles which are used to latch, suck, swallow and exhale. This can be a cistron in coping with the letdown. Even where structural issues aren't in play, medications can exist? Studies have found that having an epidural during labour to accept an effect on suck-swallow-breathe coordination for up to a month, for example.  The study stopped at ane calendar month, so we really take no idea how long the suck-swallow-exhale might actually be affected.

In some cases an anatomical result tin can certainly exist the cause - something similar a tongue tie, which impacts on tongue movement and power to deal with the letdown, merely this needs to be fully assessed.  Noisy feeding and choking/spluttering is absolutely not plenty to diagnose.  A small baby experiencing all this may take a much more normal sounding feed if positioned dissimilar, perchance with some breast shaping to aid form and stabilise the breast.  A few weeks later he may no longer demand this help.

Perhaps information technology'south none of these things. Perhaps information technology's just the mode breastfeeding is being managed. Perhaps you are focused on feeding at certain times? Maybe you are feeling engorged? Mayhap you are still in a lilliputian pain and are belongings off feeding for a short time subsequently yous see early cues. Any of those factors which lead to the breasts being fuller increases the force per unit area in the breasts and consequently the speed of the letdown.

Is block feeding the answer?

Generally non!  The basic premise of cake feeding is to divide the day into blocks of time and to feed from 1 breast during each block thereby reducing stimulation and milk production. It works! It works very effectively and very apace, and that means information technology needs caution. If your baby is struggling merely not gaining excessively (which is the more likely scenario) then block feeding will mean that you reduce your supply and that may impact your baby'due south weight proceeds and growth. Block feeding should more often than not simply be used if a baby is gaining over 1lb a week, and even then I would urge some caution.  It would only exist used for a few days and there are lots of other options to try before blocking.

See the large picture

While block feeding may help for true oversupply, where the issue is simply infant being an immature newborn, cake feeding may hinder rather than aid.  It may stop the choking/gagging but at the toll of limiting that baby'south source of diet.  Milk supply is being prepare in the first v weeks so it makes sense to exist cautious about reducing milk volume in that time.

Often nosotros need to simply consider the normalcy of what is happening - an increasing volume of milk and an immature baby! Breastfeeding is a holistic process and nosotros need to manage information technology in that way. Many times all that is needed is a change in position. If we accept difficulty keeping up the flow of h2o in a glass we simply lower the glass and so that it flows more slowly. The same principles apply. Shifting your body so that your babe is lying more on top of you means that gravity slows the flow. Sometimes that is all that is needed. That position can often deepen the latch, which also helps. All you demand to do is lean back. If your baby is still struggling in that position information technology can help to only remove the letdown from the equation altogether. You tin just unlatch when your babe begins to struggle and permit the milk spray into a muslin or hand towel and then relatch when the menstruum slows again. Some babies practise this all past themselves as they have worked out that it'due south easier that way.

It's also important to realise that some noises are normal.  The odd smacking/chucking/clicking noise is pretty normal.  Virtually young babies will do them here and at that place.  That's very unlike to a baby feeding where yous are hearing it very frequently throughout the feed.  For these babies looking at breast shaping can help to go a deeper latch.  If this isn't helping I'd suggest seeing an IBCLC or breastfeeding counsellor to await at what might be happening.

For nigh babies, clicking/smacking/gagging is a temporary issue. Maybe it's because the baby just gets more mature each day or considering any nativity problems accept resolved. Possibly he learns to manage the new faster volume, or maybe it's because supply and infant have just got into a better sync. In fact it's likely that in a couple of months the aforementioned baby volition be wanting to get that fast flow straight abroad and will let you know if he isn't!

If positioning doesn't help, or getting a improve attachment doesn't help, or you are considering block feeding, look for experienced breastfeeding support.  The correct supporter for you will look at the breastfeeding pic every bit a whole, and every bit y'all and your babe equally one unit. See the big picture. Our babies are still learning to feed in these early weeks and their muscles and fretfulness still developing. A fast letdown isn't something that necessarily needs fixed, in fact in tin can be a actually reassuring sign that your milk supply is edifice nicely. Oft we but need to support our babies while their feeding matures.

If you lot accept any questions about a consultation or would like to arrange to meet, please get in touch.

Get in Touch

Virtually the author

Carol Smyth

I am an IBCLC (International Lath Certified Lactation Consultant) in private practice in Northern Ireland and a La Leche League Leader with La Leche League of Ireland

Important Information

All textile on this website is provided for educational purposes only. Online information cannot replace an in-person consultation with a qualified, independent International Board Certified Lactation Consultant (IBCLC) or your wellness intendance provider. If you lot are concerned about your health, or that of your child, consult with your health care provider regarding the advisability of whatever opinions or recommendations with respect to your individual situation.

Source: https://www.carolsmyth.co.uk/breastfeeding-resources/posts/2015/may/my-baby-is-clicking-or-gagging-when-feeding-is-it-fast-letdown-is-it-oversupply-is-it-tongue-tie/

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