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Breastfeeding Problems Associated With The Infant's Oral Cavity, Head, And Neck

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Updated June 27, 2014

Breastfeeding Problems Associated With The Infant's Oral Cavity, Head, And Neck
Photo © A.D.A.M.

What is the first thing that comes to your mind when someone asks, "How is your baby doing with breastfeeding?" If you're like most women, your response is centered on how much milk you're making and how often the baby is actually at the breast. No one is going to talk about the baby's oral, head, and neck anatomy, but that is where the whole process of feeding begins. The function of this region of the baby's body can make or break the whole feeding experience. The major players are the:

  • Nasal cavity: This is the main passageway for air, which aids in purifying and moisturizing it before entering the lungs. In the front, this area is surrounded by the cartilaginous (a tough, elastic tissue) part of the nose. Underneath the nose, the hard palate provides a firm border between the nasal and oral cavities.
  • Oral cavity: This has a significant role in ingestion of food. It is bordered by the roof and floor of the mouth, the lips, and the cheeks.
  • Pharynx: The most important job is swallowing and keeping itself open, which is critical for respiration.
  • Larynx
  • Trachea
  • Esophagus

What are some of the sucking characteristics in a breastfeeding infant?

The most significant characteristics are: nutritive and non-nutritive sucking, sucking rhythm, and sucking rate. Here are the details.

Oral Abnormalities That May Interfere With Breastfeeding

  • Cleft palate or lip: There are three different types of clefts -- lip, palate, or palate and lip. The feeding issue stems from the baby not being able to form a sealed oral cavity to generate suction.
  • Short frenulum: Also referred to as "tongue-tie" or a "short tongue."
  • Retracted jaw or tongue: The tell-tale sign is when the baby's cheeks are dimpled or she makes a clicking sound when breastfeeding. Some methods to improve the situation include making sure that the baby's head and neck are properly aligned; doing exercises where you stroke and apply pressure to the tongue from the tip to the back; short-term use of a nipple shield, a flexible silicone nipple that is worn over the mother's nipple to feed.
  • Micrognathia: This is a small or "pushed back" lower jaw. On the outside of the body, the chin looks recessed. In the mouth, the tongue is positioned further back in relation to the oral cavity. It is often related to a wide U-shaped cleft palate and Pierre-Robin malformation sequence. With a small or recessed jaw, the tongue may not be able to come forward sufficiently to be properly positioned below the nipple. In addition, the lower jaw may not be well-positioned to compress the areola for productive milk ejection. One technique that may help is gently pulling forward under the jaw.

Sources:

Arvedson JC and Brodsky L. Pediatric swallowing and feeding: Assessment and management. San Diego: Singular. 2002.

Cherney LR. Clinical management of dysphagia in adults and children. 2nd edition. Gaithersburg, MD: Aspen. 1994.

Wolf L and Glass R. Feeding and swallowing disorders in infancy: Assessment and management. Tucson, AZ: Therapy Skill Builders. 1992.

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