While breastfeeding is natural, that does not necessarily mean it comes easy. One common challenge many mothers face is a baby who does not open their mouth wide enough to latch deeply. A wide open mouth is essential for a deep, comfortable, and effective breastfeeding latch. If your baby isn't opening wide enough to breastfeed well, understanding the different possible reasons can be helpful in determining the right course of action for care.
Reasons Your Baby May Not Be Opening Wide:
Not Using Reflexes. Babies are hard wired to breastfeed when they are born. Reflexes tell baby to open wide, stimulate the side-to-side head movement in search of the nipple, and then trigger them to move forward and latch with intent, followed by sucking. There can be a number of reasons babies aren't using reflexes to latch. They could have experienced birth trauma, such as cesarian, use of forceps or vacuum, very fast or long labor. They could also have trouble accessing reflexes if not positioned well at breast.
Hypersensitive Gag Reflex. Does your baby have a high palate? Is the mouth generally open with the tongue visible? If so, they may not be used to palate stimulation, and therefore are highly sensitive to taking the breast in deeply, and may compensate by sliding into a shallow latch.
Anatomical Challenges. Tethered oral tissues (tongue and lip ties) can restrict movement of oral structures. This can make it physically difficult for baby to open wide enough to achieve a proper latch, or baby with a small lower jaw may latch deeply and then slide into a shallow latch due to need for compensations.
Neck and Jaw Tension. Sometimes babies have tension in the neck, shoulders, and jaw that make it difficult to open wide. Babies need to be able to open up the neck, with the head slightly tilted upward in order to make room for the jaw to drop. If the shoulders are scrunched up into the ears, or baby is tucking their chin, then it may be hard to get a deep latch.
Poor positioning. Babies have the best opportunity to latch deeply when they are in good position: tummy-to-tummy against mom, arms hugging the breast, and head neutral to slightly tilted. If they are too low or high across mom's body, the arms get in the way, or the torso is twisted- baby may not have a good latch.
Strong letdown. If baby is overwhelmed by the flow of milk, he may pull back and clamp down to manage the flow. Ouch!
Breast engorgement. If the breasts are firm, baby may not be able to take in a mouthful, and instead may "nipple feed".
Learned habits. Whether a poor latch is the result of a nipple shield, a bottle, or baby had oral ties released- they may still present with a narrow, shallow latch even after the issues are resolved. Fortunately babies can relearn how to latch with therapy.
How to Help Baby Open Wide:
Ensure proper positioning. Hold your baby tummy-to-tummy. Bring her to breast chin-first, followed by the "Nose-to-Nipple" exaggerated latch technique. This encourages use of feeding reflexes.
For engorgement, try reverse pressure softening before latching.
Strong letdown, or a baby with anatomical differences, a reclined or biological breastfeeding position may be helpful. If simple, at-home solutions are not improving breastfeeding, then consider professional support.
Schedule a feeding evaluation with a IBCLC lactation consultant.
If you suspect oral ties, body tension, or don't see active use of feeding reflexes- Schedule with an infant feeding therapist, which can either be a Speech-Language Pathologist or Occupational Therapist.
Other providers who work on tension: pediatric chiropractor, CST, physical therapist
A baby who doesn't open wide while breastfeeding can be frustrating, but with patience and the right approach, most challenges can be overcome. Identifying the underlying cause is the first step toward improving the latch and creating a comfortable feeding experience for both you and your baby. Remember, support is available- If you are on the Kitsap Peninsula, don't hesitate to reach out to me at Nourish Therapy. As a Speech-Language Pathologist, Infant Feeding Therapist, Lactation Consultant, and Cranial Sacral Therapy provider, I aim to provide comprehensive care for mamas and babies going through feeding struggles. Schedule a phone consult to get started.
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