Baby only wants to feed on one side

Lopsided! What can I do? • KellyMom.com

…When baby prefers one side, or when supply or breast size is greater on one side

By Kelly Bonyata, BS, IBCLC

Is this a problem?
Why does it happen?
Evening things up
Persuading baby to nurse better on the less preferred side
Will baby get enough milk?

Is this a problem?

Most women notice differences in milk supply, pumping output, milk flow and/or size between breasts. As with many other things (foot size, ring size, eyesight, etc.) asymmetry is normal in humans. In some women the difference between breasts is hardly noticeable; in others it is very noticeable. There is every variation in between. This is not usually a problem in terms of the breastfeeding relationship, so you certainly don’t need to do anything about it if the asymmetry does not bother you or baby; however some mothers prefer to even things out, particularly if there is a very noticable difference in breast size.

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Sometimes babies will refuse or fuss at a breast when the let-down is slower or too forceful, or the supply a bit lower. They in turn will prefer the side which lets down more/less quickly and in which the supply is more bountiful.

Why does it happen?

Possible reasons for variations in supply/milk flow between breasts:

Normal anatomical differences. All women have one breast that has more working ducts and alveoli than the other (usually the left side, though either is normal). Some women also have differences between the two areola/nipples (inverted, flat, different shape/size) which make it easier for baby to latch on to one side than the other.
Baby’s preference for one side. Most babies have a side preference to some extent. From the start, your baby may feel more comfortable being held on one side and therefore nurse it more efficiently and/or more frequently.
Mother’s preference for one side. Mom (consciously or subconsciously) may offer one side more than the other because she feels more comfortable nursing on that side.
Breast surgery or injury. If one breast was ever operated on or injured in any way, supply and/or milk flow can be affected.

If your newborn is refusing one side, have her doctor do a good physical exam to check for birth injuries. Some babies will have an injury that goes unnoticed at birth, but causes baby discomfort when in certain nursing positions.

If baby suddenly begins to refuse one side, it could be caused by an ear infection or other illness in baby (making nursing painful or uncomfortable on that side), an injury to baby (or something else, such as a sore immunization site) that makes nursing painful in that position, or a breast infection in that breast (which can make the milk taste salty). Many babies who refuse one side do so because mom has a much faster or slower letdown on one side (baby might prefer either the faster or slower flow). If all other possible causes are ruled out and baby continues to refuse one side, then consider seeing your doctor just to rule out any breast problems.

Evening things up

It is fine to just do nothing, but if the lopsidedness is bothering you, you can try to increase milk supply on the smaller side to increase the supply/breast size/milk flow on that side. Be careful, though, not to neglect the larger producing breast too much and allow too much backup of milk in that breast, because that may make you vulnerable to plugged ducts and mastitis.

Here are some things that can help to even things up (you don’t need to do them all; start off with the one thing that looks most workable for you):

Start baby on the smaller side for each feeding for a few days (baby usually nurses more vigorously on the first breast offered).
Nurse on the smaller side twice as often. For instance if you nurse on one side per feeding, you might nurse on the small side for two feedings, the larger side for one, then back to the smaller side for the next two feedings, etc.
Pump the smaller side for 5-10 minutes after some feedings.
Add an extra pumping session (for 10-20 minutes – smaller side only) in between feedings.

If the larger side becomes overfull, express just enough milk to relieve the pressure. Most mothers notice an “evening out” of some proportion within 3-5 days of doing these things. Most moms use these measures for a short time only, until they get the desired results, but others continue long-term.

There may always be a small degree of difference in breast size – at least to your own eyes. If there is an obvious difference in appearance through your clothing, you may want want to use nursing pads to give a more even appearance. Usually a difference in size is much more noticeable to you than to anyone else.

Persuading baby to nurse better on the less preferred side

Try starting your baby on the preferred breast and then once let-down occurs, slide her over to the other side without changing the position of her body. For example, start her in the cradle position and then slide her over into the football position.
Continue to try different nursing positions.
Offer this breast to your baby when she is just waking up but not fully awake or already a little sleepy. She is more likely to instinctively nurse at this time.
Nurse in a darkened and quiet room.
Offer this side with motion; i.e. walk, sway, bounce, rock, etc. until your baby starts
nursing well.
If let-down on the less preferred side is too fast or slow, follow the suggestions in Let-down Reflex: Too slow? or Forceful Let-down Reflex
If supply on the less preferred side is low, follow the suggestions above and in Increasing low milk supply.
If baby seems to want a faster flow from the less preferred side, then try doing breast compressions to speed the flow.
See the suggestions in Help — My Baby Won’t Nurse!
Patience and persistence are key. Keep trying, and praise baby when she nurses well. Most of the time a baby will take the less-preferred breast with time. If baby is refusing or nursing rarely on one side, you may need to pump this side as often as the baby is nursing the other side in order to better maintain your milk supply.

Will baby get enough milk?

Yes – your baby can get all that she needs as long as she is allowed to nurse as often as she wishes – even if you nurse exclusively on only one side. If there is simply a difference in supply between breasts, baby will adjust her nursing to compensate. Overall milk production is generally not a concern unless other factors are involved.

If baby is completely refusing one side, you’ll want to pump that side as often as she nurses to maintain supply until you get her back nursing on that side.

If all else fails, one-sided nursing is very possible as long as your baby is allowed to
nurse without restriction. The side that you are not nursing on, once allowed to “dry up,” will be smaller than the other side. This will result in some degree of lopsidedness (though it may not be obvious), but this will remedy itself once weaning occurs.

When your baby prefers to nurse on one side

By Andrea Tran RN, BSN, MA, IBCLC

It can be frustrating if your baby shows a preference for one breast over the other. It is standard breastfeeding advice to offer both breasts and alternate which side you start a feeding with. However, some babies are not on board with that plan. I’ll explain why it might be happening and what you can do about it.

Is it common for a baby to prefer one side?

This is not an area that has been extensively studied. Researchers in Saudi Arabia did look at the occurrence and found that of 480 moms approximately 26% reported their babies exhibited breast preference.

Why do babies show breast preference?

There are a variety of reasons breast preference may occur.

Greater milk supply on one side. This is common. One study reported mothers who were exclusively pumping documented an equal volume pumped from both breasts less than 3% of the time.
Differences in nipple size or shape
Breast preference in the early days of nursing may be due to bruising of an infant’s head. If this is the case the preference will probably be short-lived.
Infants with torticollis, or a “stiff neck”, may be more comfortable laying on one side over the other.
A child with an ear infection may fuss or cry if positioned with that ear down.
A mother may be more comfortable holding her child on one side over the other due to hand dominance.

Is it a problem for me if my baby prefers one side?

If one breast is producing most of your baby’s milk you may have one breast that is noticeably larger than the other. Sometimes this leads to issues with clogged ducts. If you don’t experience that, your baby’s breast preference is not a problem from a health perspective. However, if a lopsided appearance bothers you, you can try to help your baby take both sides equally.

Related: How to get rid of plugged milk ducts and prevent them from happening

Is there anything I can do to help my baby take both breasts equally?

Having success in getting your baby to take both breasts will depend on the reason for the breast preference.

The amount of stimulation a breast gets can affect how much milk is produced on each side. You could try doing some pumping on the non-preferred side after breastfeeding. Breast compressions while nursing can help increase the flow and aid in thoroughly draining the breast.

If breast preference is occurring due to an infant’s discomfort from a bruised head, torticollis or ear infection using the football hold may make it more comfortable for a child to take the non-preferred breast.

If the reason for the breast preference is unknown a mother could try offering the non-preferred side first at every feeding for a few days to see if that helps her baby get over what is causing the breast preference. Infants may be less picky when they are hungrier. Mom may want to pump the other side if it is not getting drained adequately.

Another recommended technique is to latch the baby on the side they like better and then after a few minutes try gently detaching them and sliding them over to the other breast.

A lactation consultant can help you determine the reason for the breast preference and guide you through these techniques.

What should I do if my baby refuses to take the other side?

Initially, I would recommend pumping that side. If all the above techniques do not change your baby’s mind and your baby is gaining weight at an adequate rate you can accept your baby’s preference and wean off the pumping. What is most important is that your baby gets the amount of food that he needs to grow properly. If that can happen by feeding on one breast the breast preference does not need to be an issue.

Sources

Al-Abdi S.Y., Al Omran S.A., Ali Al-Aamri M. A., Al Nasser M.H., and Al Omran A.M. (2015). Prevalence and Characteristics of Infant's Unexplained Breast Preference for Nursing One Breast: A Self-Administered Survey. Breastfeeding Medicine, 10:10, 474-480. https://doi.org/10.1089/bfm.2015.0116

Hill, P. D., Aldag, J. C., Zinaman, M., & Chatterton, R. T. (2007). Comparison of Milk Output Between Breasts in Pump-Dependent Mothers. Journal of Human Lactation, 23(4), 333–337. https://doi.org/10.1177/0890334407307575

Andrea Tran RN, BSN, MA, IBCLC is a freelance writer who has been helping moms and babies breastfeed for over twenty-five years. She is married and the mother of three adult children.

What to do if the baby takes only one breast - "Healthy baby's online cabinet"

Ksenofontova Olga Leonidovna

Deputy chief physician of MBU "EKPC"

First of all, you need to understand the question - did the baby always prefer the same breast, or had there been no problems with alternating breasts before? If a child initially has a tendency to breastfeed with one breast, it is possible that he has problems with the cervical spine and neck muscles. On the other side and at the other breast, it is simply uncomfortable or painful for him to lie. This problem will be solved by a neurologist or pediatrician during examination, and this is usually detected almost once - in the first weeks of feeding. Then, for the duration of treatment, you should choose comfortable positions for feeding at both breasts - it can be from under the arm, hanging over the baby, in a cross cradle, and so on, the main thing is that the position of the child’s body is convenient for his muscles.

If the child does not have physical health problems, the reason for the refusal of one breast may be in the formation of the refusal as such. The baby may be sucking on a pacifier and developing nipple tangles, or selectively rejecting one breast in any position because it contains too much milk. And then, at the beginning of feeding, it pours too much from it, which makes the baby refuse it in favor of another breast - softer and with less pressure. Perhaps the reason for the refusal is the psychological discomfort of the baby - it is inconvenient for the mother to reproach the child with one of the breasts. She is not so comfortable putting the baby to her chest, and he catches this on a subconscious level, refusing the “unloved” breast. Sometimes the refusal of one breast is a kind of “demonstration of strength” by the baby and a way to control the mother, a kind of whim of the baby. Sometimes the breasts can be somewhat different from one another - it is easier and easier for the baby to get milk from one breast than from the other. And then the child can refuse a more “complex” breast in favor of a simpler one.

First of all, do not panic and be nervous. With a strong nervousness of the mother, the baby may refuse the breast completely, feeling her physical and emotional stress. At the same time, the mother’s milk in a state of stress is “clamped” by oxytocin in the chest and it becomes more difficult for the baby to get it. Pull yourself together and calm down. But you need to correct breast rejection at its earliest stages, until the baby has switched to breast rejection altogether or you yourself have come to terms with the fact that you will feed from one breast for the rest of the time. First of all, you need to understand for yourself that you are the mother of this baby and you are the leader in your couple, you are the main one and you will need to decide which breast and which of the feedings you will give to the baby. Feeding on demand implies not only the requirements of the baby itself, but also the requirement of the mother - if she has chest discomfort or a feeling of breast fullness, if she needs to feed in this situation with her left or right breast. It is extremely important to understand this for yourself and follow this rule. You need to be completely confident in yourself and in the correctness of all your actions. However, in such a delicate situation as the beginning or already completed refusal of the breast, you should not go too far either, insist on your opinion and breastfeeding with a certain breast should be extremely delicate, since violence in terms of breastfeeding can turn the situation in the opposite direction to you.

How to start the process of dealing with the rejection of one breast? First of all - change the program - that is, feed the baby with the unloved breast in an unusual position for him or use non-standard places for feeding him, sometimes you can feed the child with the unloved breast on a walk, in the kitchen with the noise of working appliances, in the car while traveling on business . Do the same when feeding for falling asleep: always start feeding by offering the baby his favorite breast, and when the baby starts to fall asleep, quickly change the breast to the one that he does not take well. Offer the same breast at night. When the baby wakes up for feeding, half-asleep children are usually more willing to agree to an unloved breast, if only to cling to their favorite milk faster again. Can be used to persuade you to take an unloved breast sources of white noise hair dryer, noise or splashing of water, sounds of nature or light music. Usually, breast rejection does not last long, and if you quickly eliminate the cause of discomfort and cope with your tension within yourself, then the child will quickly again be evenly applied to one and the other breast.

If you let the situation take its course, you can get a categorical rejection of the breast because there will actually be less milk in it due to its low stimulation. Then the baby will be capricious and offended by the lack of milk when trying to suck, and over time will refuse one breast altogether. Then you will have to feed with one breast, which entails a chain of new problems, for example, the formation of different breast sizes.

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Why a baby takes only one breast: a doctor's explanation

Baby

Photo: Getty Images

Many breastfeeding mothers note that babies take one breast more often than the other. Usually this symptom is explained by the fact that one of the mammary glands produces more milk, it comes out easier, it is more convenient for the child to grab the nipple. However, it is not a matter of taste or improper attachment, because the child has no complaints about the other breast. But this may be one of the signs of a birth injury: a displacement of the bones of the base of the skull and a turn of the cervical vertebrae, manifested by torticollis.

The baby takes one breast because it is easier for him to turn to that side. For example, it is easier for a child to turn his head to the right side. Then, if you feed him in front of you, it is easier for him to take the left breast. And vice versa.

For a woman, feeding predominantly on one breast undoubtedly leads to uneven loading and the appearance or increase in breast asymmetry after the end of breastfeeding, which in itself is a serious reason to pay attention to this symptom.

Cranioposturologist, osteopath

Signs of torticollis

You can easily see them yourself:

the baby prefers to turn and tilt the head in one direction. Usually the head is tilted to one side and simultaneously deployed to the other. Especially clearly this symptom is noticeable in a dream, when the child involuntarily puts his head in the most convenient position for him.
the baby's neck is short, it seems that the head sits directly on the shoulders - the so-called puppet neck syndrome. It appears due to strong muscle tension. This is a kind of protective reaction to the existing birth trauma.

To check for torticollis, lay the child on their back with the head exactly in the center. If she turns a little or leans to the side, there should be no doubt - the child has mechanical disorders and they need to be treated, the sooner the better.

Why torticollis appears

Problem in the joint between the first cervical vertebra and the occipital bone. There, subluxation occurs - from slight to significant - and, as a result, the head assumes an incorrect position.

Most often, subluxation occurs due to birth trauma. The neck muscles of the child during childbirth were too stretched and twisted, the vertebrae were also displaced, the intervertebral ligaments were stretched. The neck reflexively tightens to limit the mobility of the cervical region, relieving it of pain when moving. When the child grows up, the neck becomes short and plump, muscle tension does not go anywhere.

Causes of torticollis

difficult, too fast or too long labor
administration of oxytocin or epidural anesthesia
if the child was squeezed out
torticollis often occurs during caesarean section.

However, it may be present even if everything went perfectly in your opinion. Mom and baby can have a completely different birth scenario. The most common discrepancy is that the mother says: “I gave birth quickly, easily, in 3 hours.” And for a baby, this means a rapid birth, one of the reasons for significant injuries.

Photo: Getty Images

How to treat torticollis

Birth trauma and its consequences require treatment. Having cured torticollis, you will, of course, ensure that the child will still take both breasts well. But the main thing is to eliminate the risk of scoliosis in the future. If this symptom is left unattended, over time, all parts of the body will shift slightly. The incorrect position of the bones will determine the deterioration of blood flow in the brain. In a favorable case, the child can develop normally, but he will lack the intensity of arterial blood flow through the cerebral vessels in order to develop more actively and correctly.

Recommended careful restoration of the position of the bones of the skull. Massages in this case cannot have only a partial effect. The sooner you turn to specialists, the better the result will be. From experience, a baby with severe torticollis who has already gone will have to be treated for at least a year, sometimes for several years. If you contact the child even before he begins to sit, it will be much easier to fix the problem. When time is lost, and the child has already grown up, it still makes sense to show it to an osteopath: before puberty, it is possible to cure a birth injury and correct its consequences almost completely in most cases.