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Clicking noise when baby bottle feeds


Why does my baby click when they eat? — Mattos Lactation

Read time | 10 minutes

When I wrote on the causes of clicking during breastfeeding last year, I had no idea that it would quickly move to the first page of google.

I knew hearing clicking noises during feeding was a common occurrence for parents, but I couldn't have imagined that a short, poorly written post would become my highest performing post to date, with over 3,050 views since posting. 

While my understanding of clicking during infant feeding hasn't changed much, my ability and desire to create easy to understand, in-depth blog posts has increased. 

Therefore, I want to tackle this topic again, but in a manner that is true to me, resulting in an article that I don't shake my head and wonder, "Shondra, what were you thinking to post this unhelpful, pointless trash?"

What is Clicking?

In this context, clicking describes a short, sharp sound created from a baby's mouth. It sounds similar to a "tsk tsk" sound one makes if they're demonstrating disapproval (or "tut-tut" for my UK folks), though some might better relate to the ICONIC tongue popping sound popularized by the queen Alissa Edwards.

When it comes to baby, the clicking sound isn't as sharp or consistent as tongue pops made by adults, but once you're familiar with the general sound, identifying clicking variations during infant feeding becomes easy. 

What causes clicking?

Clicking is caused whenever there is a loss of suction. This can happen both at the breast or on the bottle, and may or may not be seen in conjunction with more obvious signs of "breaking the seal" such as leaking. 

How the clicking noises sound- sharp and bright or muffled- can depend on which part of the tongue loses suction, which also explains why for some, milk spilling from the baby's mouth accompanies the clicking, and for others, there's just the sound.

Note: There can be leaking without clicking too, which also provides useful information for troubleshooting feeding difficulties.  

Is clicking a problem?

Though I would argue that clicking sounds aren't normal, I wouldn't say it's always a problem. 

For example, if your baby makes the occasional clicking noise or if it's during a time of intense breast fullness, there's generally nothing to worry about.  

Consistent clicking during feeding, however, especially in conjunction with other signs of feeding difficulties, such as nipple pain, slow weight gain, coughing, choking, gasping, panting, unlatching, grimacing, should be evaluated, even if it occurs during bottle-feeding.

Why is my baby making clicking noises?

There are many reasons possible causes for clicking. 

  • Poor positioning/latch

  • A strong, forceful letdown

  • Engorgement 

  • Poor tongue mobility/function (Such as tongue tie)

  • A weakness of the tongue 

  • Inability to maintain a seal due to weak muscles or restricted lip (lip tie)

  • Body tension or physical limitations such as Torticollis

  • Hard Palate abnormalities

  • Submucosal cleft

  • Ear Infections

  • Thrush

Let's take a look at each case separately.

Poor latch & positioning

Oft, the phrases latch & position are used synonymously. Still, they describe two distinct steps- the latch refers to how your baby's mouth attaches to the breast or bottle and position relates to your baby's physical arrangement and orientation in space and in regards to the feeding parent. 

To make it easy

Latch = mouth. Position = body. Latch =/= position.

A baby's position can, and often does, affect how effectively a baby latches and how well they can transfer milk ( a whole different & distinct step of feeding!) 

An issue with the latch OR the position can cause clicking in some babies, in which case, mastering the latching technique and finding the right feeding position to support your baby's feeding ability may be all that's needed to achieve quiet feeding. 

The act of mastering latching is many times easier said than done. Even after reading this excellent FREE 24-page latching guide, some parents will need additional latching support and troubleshooting. 

Luckily, even if you live in an area short on IBCLC's, there are often many experienced lactation professionals who can help with latching basics and refer when necessary if tailored latching help doesn't resolve the issue. 

A strong, forceful letdown

Just as some are "blessed" (or "cursed" depending on who you ask) with very robust milk supplies, some are "blessed" with an extraordinary rate of milk flow. 

Though forceful letdowns & oversupply often go hand and hand, forceful letdowns (Overactive Milk Ejection Reflex [MER]) can happen in those with "typical" milk supplies. However, the underlying cause may be different. For example, full breasts often accompany oversupply, which may result in a forceful letdown due to the pressure build-up inside the mammary glands. The first letdown, and even the second, may be mighty as the breast releases the milk with a force that rivals Niagra Falls.   

With Overactive MER, rather than the force stemming from milk volume, the power is due to an overachiever reaction on the part of the pituitary gland( which sends out the hormone that tells the 'milk sacs' to contract and send the milk out the breast). 

As you may imagine, regardless of the cause, your baby can easily become overwhelmed with the rate of milk and release tongue suction to allow milk to spill from the sides of their mouth so they can breathe. 

If the flow rate is the cause of the clicking, strategies tailored for managing overactive letdowns, along with more upright & laidback feeding positions, should resolve the clicking. 

Engorgement

This cause is pretty simple: Full, taut breasts are hard to grasp on to, so during periods of intense engorgement or fullness, clicking may occur. 

Resolve the swelling or reduce breast fullness, and the clicking should stop. 

Poor tongue mobility/function (Such as tongue tie)

Poor tongue function is NOT always caused by tongue-tie, however, tongue-tie often causes poor tongue function thus impacting its range of motion (mobility).

There are many stages of the feeding and swallowing process, and a limited function of the tongue can impact each of the required steps. 

The clicking sound associated with poor oral function due to tongue-tie can be broken down to this straightforward overview-

A tight frenulum doesn't allow your baby's tongue to raise to the proper placement for easy feeding OR the effort it takes your baby to overcome the resistance of a tight frenulum is such that they quickly get tired and start to lose suction.

Reduced tongue mobility is the most common cause of persistent clicking I see. There is such a strong association with clicking and tongue ties, that clicking alone is enough to prompt a tie suspicion even in the absence of "typical tongue-tie appearance."

A weakness of the tongue 

The tongue is a group of muscles, and with any muscles, it can be or become weak. Weakness may be a byproduct, which is commonly seen with tongue-tie and explains the need for tongue strengthening exercises pre and post revision, but can be a stand-alone cause of clicking.  

It takes an experienced and highly trained professional (such as IBCLCs who specialize in supporting tied babies) to be able to differentiate between limited tongue function caused by weakness vs. reduced tongue mobility caused by ties. 

Inability to maintain a seal due to weak muscles or restricted lip (lip tie)

There is a profound link between tongue mobility and many other structures of the body (see below), to include the lips and surrounding oral muscles. Any weakness or limitation of any oral anatomy has the potential to impact tongue function. 

Body tension or physical limitations such as Torticollis

See above. Insert body tension/physical limitation in place of muscle weakness/lip tie. 

Hard palate abnormalities

The hard palate is the bony part of the roof of the mouth. We expect the palate to be intact with a gradual slope.

Sometimes there are abnormalities in the palate, be it due to congenital defects (such as cleft palates) or due to abnormal development caused by a lack of appropriate palate pressure in utero (ex: bubble palates).  

During breastfeeding and bottle-feeding, the palate provides a platform for stabilizing the breast/teat in the oral cavity. Palatal abnormalities can impact stability, and clicking can result. 

Submucosal clefts/ Velopharyngeal insufficiency (VPI)

Generally speaking, clicking sounds often come from the anterior portion of the mouth, and some may argue that clicking doesn't occur with submucosal clefts or VPI.

I wanted to add this category because how parents and providers interpret clicking is subjective. And because clicking noises already vary in sound and intensity, I don't think it's too much of a stretch to include sounds that may be loosely considered clicking. 

Milk leaking from the nose during feeding is a classic symptom of submucosal clefts/VPI and will always require a referral for further evaluation. However, sometimes a soft puffy "clicking-esque" noise may be present due to loss of suction of the soft tissues near the throat and would also warrant a referral.  

Ear Infections/ Thrush

Thrush & ear infections both can change the way your baby eats, and temporary clicking may occur. Once the thrush or ear infection resolves or the pain disappears, the clicking noises should stop as well.

I'll admit, I'm biased, but ff your baby suddenly starts to click and around the same time, you notice you're having some breast pain, it would be good practice to schedule a lactation consultation. During the consult, we will assess what's causing the pain and develop a care plan to reduce the discomfort. 

As you may see, there are a lot of possibilities for your baby’s clicking. In many cases, when clicking persists despite position changes and after engorgement passes, the clicking is due to something structural. 

I often find myself asking if there’s any clicking present during feeding when parents complain of pain, slow weight gain/weight loss (baby), and low supply.  

The reason?

Babies need a proper seal to maintain vacuum pressure to transfer milk effectively and efficiently. 

Many times parents are told that clicking is typical, or that there are no issues with their baby’s noisy eating, even though they sound similar to the baby below. 

The baby in this clip is NOT feeding efficiently at all. Continued poor feeding is often very stressful for babies (and parents) and can lead to long term feeding aversions. Clicking may be the only noticeable sign of dysfunctional feeding, especially when babies are gaining weight or having appropriate diaper output. 

If your baby is making clicking noises that persists or if they leak, gulp, gasp, pant, pop off or grimace and fuss while feeding (bottle or breast), please download this DIY Oral Assessment worksheet. 

Once completed, you will have a better understanding of your baby’s oral strengths and weaknesses.  The sooner we find solutions to make feeding easier for your baby, the better. You can book an appointment here.

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How To Stop Baby From Clicking While Bottle Feeding?

Baby

ByWinters

Hours

Updated:

Your bundle of joy is here in your lap and feels happy when you are around. Your baby communicates with you by making different sounds and noises when they are happy or cranky.

“Sometimes parents might notice a clicking sound when they start bottle feeding the baby. You as a parent might observe this sound to be a different one. And you will wonder why this clicking sound comes when you feed your baby from a bottle.

Well, the clicking sound starts when your baby is breaking tight seals around the baby bottle nipples that he made with his lips during feeding from the bottle. ”

The next thing is how to stop it. You can stop it by knowing its cause.

Let’s find out why clicking sounds occur and how to stop the baby from clicking when bottle feeding.

What are clicking sounds?

Clicking sounds are produced due to loss of suction. It can occur due to some reasons, out of which some would require a consultation with the pediatrician while some are not to be worried about.

The sound is similar when we touch our tongue with the palate and then push it down. Sounds like “tsk tsk”

Your baby is breaking seals around the nipple of the bottle while sucking from it.

Why is this happening, there are reasons that I will discuss. So keep reading to know more about clicking and how to stop it from happening.

Reasons behind the clicking sounds

There are reasons behind the clicking sounds produced during bottle feeding and these are:

Improper feeding position

If you are feeding your child at the wrong angles then it will cause a clicking sound as the baby is unable to feed in an improper or poor positioning.

Make an angle of 45 degrees so that the baby can easily bottle feed and the mother should also be in a comfortable position. Bad positioning will lead to clicking sounds by the baby when feeding.

The nipple shape is not correct

The nipple shape might be a problem that is interfering with the baby’s bottle feeding and that’s why clicking sounds are occurring. Nipple should have a narrow base and a gradual slope that will allow your baby to take all or most of the silicone portion of the nipple into their mouth and seal their lips.

Nipple size is not correct

The larger the nipple size the faster the nipple flow rate of milk supply. A fast rate of milk flow will cause the inability of the young one to swallow it, it might lead to choking and coughing as well.

If the milk or infant formula is flowing too fast for the baby, you will notice your baby breaking the suction and the milk escaping out of the side of their mouth.

And if the nipple size is small, the slow flow rate of milk will also cause frustration and crying in the baby. And there are chances that the baby will produce clicking sounds as he/she is unable to get the feed properly.

Baby is not hungry

Babies are not hungry all the time and sometimes they use a bottle to comfort themselves by just chewing it. This also produces a clicking sound.

Nasal congestion

In winter it happens most of the time that your baby may get nasal congestion and will give clicking sounds when bottle-fed. These will go away once congestion ends.

To relieve congestion put a drop of nasal saline in the nostrils so that the baby can have milk properly.

Oral thrush

The itching and sore mouth caused by oral thrush will result in clicking sounds. It will go away once you get treatment from your pediatrician.

Ear infection

Another infection that might be troublesome is an ear infection. Babies might exhibit fever and frustration. Sucking and swallowing can cause pressure changes in the middle ear that may increase ear infection pain. Baby will break the seal repeatedly to relieve pressure, and will produce clicking sounds.

Tongue tie

Tongue-tie (ankyloglossia) is a congenital disorder where the infant has a restricted range of movement of his/her tongue.

The tongue-tie condition causes an abnormally short, thick, or tight band of tissue (lingual frenulum) to bind the tongue’s tip to the floor of the mouth, which may obstruct bottle feeding.

Babies with tongue ties have to swallow milk while feeding. In addition, reduced tongue mobility leads to tiredness resulting in losing suction while bottle-feeding or breastfeeding. This will happen most of the time so it is best to see the doctor. Usually, a surgical procedure relieves this condition.

Cleft palate and lip

Clefts in the upper lip, the roof of the mouth (palate), or both are considered cleft palate and lip. When a kid is growing in the womb, his or her facial tissues must close, but sometimes they don’t. This may cause a cleft lip or cleft palate.

The biggest challenge will be feeding and the baby will produce sounds due to improper latching or shallow latch. Surgical intervention can correct it.

Teething

At around 6 or 8 months your baby will chew on a bottle due to teething. While taking a bottle, the infant may constantly break suction to release pressure from the gum. This will go away with time as it’s a temporary phase.

So how to stop the baby from clicking when bottle feeding?

Now we know three reasons that are causing it so we can correct them by taking the following measures.

Make proper feeding position

Feed the bottle to your young one in the proper or ideal position as mentioned earlier. Do not make the baby lie flat or straight up. It should be at a 45-degree angle and hold the bottle horizontally.

Change the nipple size of your baby’s bottle

Change the size of the nipple and use which fits better with your baby’s mouth so that he/ she can have a proper latch.

Keep track of feeding time

By keeping track of your baby’s feed time you will provide a bottle when he/ she is hungry.

Get medical advice or interventions when necessary

Babies with tongue tie, cleft palate or lip, and infections of the mouth, nose, and ear all need medical attention and advice. So do consult your pediatrician.

Conclusion

From the above discussion, we can conclude that

  • Clicking sounds are produced due to loss of suction and improper latching of baby when bottle feeding.
  • There are many reasons, some need to be taken seriously to avoid any dangerous consequences. While others can be improved by taking proper measures at home.
  • If clicking sounds are bothersome then consult your health professional or health visitor in time.
  • Take care of your young one and always stay vigilant.

Faqs:

Why does my baby make noises while feeding?

Your baby may not be sucking correctly if she makes clicking sounds or dimples her cheeks when breastfeeding. Even if you’re certain she’s in the proper position, double-check, particularly if your nipples are hurting. Nipple pain is often caused by poor placement and latch-on.

Can babies drink breast milk too fast?

A quick or powerful flow is not always an issue for a baby. Many newborns like the faster pace and milk spurting from the breast are entirely natural. Some newborns, however, may seem to be overwhelmed and irritable as a result of a rapid let-down; they may cough, choke, or lose go of the breast and scream.

How quickly do breasts refill?

As previously stated, the breast is never fully empty, although feeding reduces milk flow to the point where no considerable quantity is secreted. It normally takes 20-30 minutes to restore acceptable flow and closer to an hour to restore peak flow.

How do doctors check for tongue-tie?

Tongue-tie is usually discovered during a physical examination. In the case of babies, the doctor may utilize a screening instrument to assess several characteristics of the tongue’s appearance and movement.

Do tongue-tied babies have trouble breastfeeding?

Some newborns with tongue ties nurse effectively right away, while others do so until posture and connection are addressed. However, any tongue knot that inhibits normal tongue mobility might cause nursing issues.

Do babies with tongue-tie sleep more?

Because of the sub-optimal resting posture of a tethered tongue, a kid who has one may tend to mouth-breathe and/or rely excessively on a dummy to sleep. Both of these may cause nocturnal waking and restrict deep, restful sleep in a variety of ways, presenting as “simply” a sleep disorder.

References

https://www.mayoclinic.org/diseases-conditions/tongue-tie/symptoms-causes/syc-20378452

https://www.mayoclinic.org/diseases-conditions/cleft-palate/diagnosis-treatment/drc-20370990

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Tongue tie and infant feeding specialist

In the Northeast, we specialize in supporting babies with strabismus and mothers with feeding problems.

We provide a medical procedure, Tongue Tie, also known as Tongue Tie Relief, for all babies, helping mothers who are breastfeeding or bottle feeding.

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At Tongue Tie North East we provide this procedure for children under 9months.

What is tongue frenulum?

A lingual frenulum is when a thin skin membrane (lingual frenulum) attaches the tongue to the floor of the mouth or the lower edge of the gums, which restricts tongue movement. It can attach to the very back of the tongue (posterior), in the middle, or to the very anterior tip of the tongue (anterior).

The procedure for splitting a child's tongue frenulum is called a frenulotomy. The membrane under the tongue is split to allow for optimal tongue movement and function, helping babies suckle more effectively.

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Function of language is more important than appearance.

Why choose Tongue Tie North East?

Care and support

Holistic client-led care, reassuring, leisurely, non-judgmental approach and caring environment Evidence-based practice with clinical experience, advanced competence in the treatment of all variants of the frenulum of the tongue.

5 stars


Service

Complete medical report with before and after photos. Postoperative follow-up and telephone consultation available. Extra support at the clinic so you don't have to hold your baby during the procedure.

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How do you spot a tongue tie?

Some lingual frenulums may be found during a newborn examination, usually performed by a pediatrician. or a midwife with additional powers; others may be diagnosed while the mother and baby are still receiving postpartum care, or when the baby is older, by a health visitor, a lactation specialist, or a general practitioner. The following clues may be present;

  • If your baby has any problems with breastfeeding or bottle feeding, you should seek the advice of a healthcare professional who has been trained in tongue tie assessment.

  • Visible membrane or "thread" that connects the tongue to the lower gums or floor of the mouth.

  • The tip of the tongue may be "flat", "heart-shaped" or "serrated" at the tip.

  • The tongue does not rise completely to the palate, which is especially noticeable when the baby is crying. It may also be "rectangular" when raised, or stick out rather than pointed.

  • The center of the tongue may be "humped" or hollowed out when raised.

  • The tongue may not protrude beyond the lower gums, so it does not protect the nipple from pressure during breastfeeding, resulting in injury, compression or curvature of the nipple.

  • Bad attachment may cause the baby to slip off the nipple.

  • Bad latch on the nipple of the bottle, allowing air to be inhaled

  • During feeding, milk flows along the edge of the mouth

Reasons for treating the ligament of the tongue

Tongue ligation treatment is a simple procedure called frenulotomy (sometimes called frenotomy or frenulectomy). Not all babies and children with strabismus require treatment, and some can do without it. The National Institute of Clinical Excellence (NICE guidelines) national guidelines suggest that frenulotomy is generally safe for young children and may help with feeding problems. Frenulotomy may be recommended for children under 6 months of age, if available;

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Feeding difficulties, which may or may not include the following;
;

  • Poor weight gain

  • Perenial jaundice

  • Broken frequent feeding

  • Feeding the child “All the time”

  • The child looks unsatisfied after feeding

  • 9000

  • Shaking head or waving hand when approaching breast for feeding

  • Clicking, "squishing" sounds may be present.

  • Milk leakage during

  • Premature falling asleep during feeding

  • multiple attempts to capture or maintain the capture of the “slippage of the nipple”

  • The use of adapted breast milk or artificial milk additives

  • Excessive cough, suffocation, vomiting, colic and reflux

  • Limited Language Movement

Difficulties with breastfeeding for mothers may include:

  • Crowning and concerns leading to pain, damage, tissue loss

  • Incomplete milk production by the baby, leading to engorgement and/or mastitis

  • Poor initiation and maintenance of mother's milk production

​

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The presence of only visible or anterior submucosal layer (occult/posterior tongue ligation) is not an indication for frenulotomy treatment. Tongue mobility is a critical factor influencing feeding.

In the UK, the National Institute of Clinical Excellence (NICE) guidelines govern our practice of treating squint. NICE states that tongue ligation separation procedures should only be done to help mother and baby feed more efficiently. Frenulotomy should not be performed due to parental concerns about their child's future ability to speak, eat, or for cosmetic reasons.

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What to Expect After a Frenulotomy

After the procedure, some mothers and their babies experience immediate improvement in nutrition. For others, it will take longer, sometimes weeks or more, for feeding to improve as the baby learns new feeding habits. By having a tongue tie, both mother and child have adapted to feeding in order to overcome their difficulties.

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After the procedure, some mothers may take some time to gradually stop using... e.g. nipple shields, feeding expressed breast milk or formula milk with a finger or syringe while their breastfeeding gradually improves .

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It is important that you consider frenulotomy as part of a plan to improve your nutrition; it's not always an instant decision.

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Tongue Tie North East highly recommends post-procedure body work by visiting either a pediatric chiropractor or a cranial osteopath.

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Philips Avent SCF030/27 Feeding bottle (2 pcs) Natural 125 ml, 0 mo. +

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Natural bottle with ultra-soft nipple that mimics the feeling of breastfeeding. Wide breast-feeling spiral nipple with petals for extra comfort promotes natural cuddling and makes breastfeeding and bottle feeding effortless.

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Philips Avent Feeding bottle (2 pcs) Natural 125 ml, 0 mo. +:

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