Baby Choking On Breastmilk: Why Does It Happen And What To Do

If you see your baby choking on breastmilk, it could be because their swallowing skills aren’t fully developed. Choking when breastfeeding can result in innocuousⁱXNot harmful to one’s physical or mental health. coughing. Further, milk can sometimes make its way into the lungs, causing aspiration pneumonia (1).

If your baby has rapid breathing, turns blue, or becomes unconscious from choking on breast milk, get emergency medical attention. If your baby has experienced many choking incidents, you might want to see a pediatrician.

Read on to learn more about the reasons for choking in babies, preventive measures, and what to do if you find yourself in this scenario.

Why Does A Baby Choke While Breastfeeding?

A baby can choke on breastmilk due to various reasons ranging from normal immature swallowing to feeding problems due to anatomicalⁱXOf or about the body structures or anatomy. or functional disorders. It can also be due to maternal factors.

The main causes of choking while breastfeeding can be (2):

• Oversupply of breast milk: Faster milk flow is one of the major causes of choking on breast milk. Infants may not be able to swallow quickly. This may often happen if the mother has an oversupply of breast milk. The baby may bite while breastfeeding due to the overflow of milk, thus making swallowing further difficult.

• Overactive letdown: It is the forceful ejection of milk when your baby is sucking. Let down reflex is controlled by oxytocinⁱXA naturally occurring hormone that controls the male and female reproductive systems and impacts labor, childbirth, and lactation. hormones. Increased release of breast milk can cause gulping, coughing, or choking in infants.

Dr. Joanna E. Perdomo, a board-certified pediatrician from Nicklaus Children’s Hospital in Miami, Florida, says, “Babies may choke or cough when breastfeeding. This usually happens near the beginning of a feed when the milk letdown may be too strong or forceful for the baby to handle.”

Infants who have feeding difficulties are associated with a high risk of choking while breastfeeding or bottle-feeding. The following congenitalⁱXA condition or trait that is present at birth. abnormalities may result in feeding problems (3)
.

• Developmental delay

• Neurological issues such as cerebral palsyⁱXA combination of disorders that affects the muscle tone and impairs one’s ability to move, balance, and maintain a healthy posture.

• Down’s syndrome

• Structural anomalies of oral, respiratory, or feeding structures, such as cleft lip and palate and Pierre Robin syndrome

• Gastrointestinal issues, such as tracheoesophageal fistula

• Congenital heart diseases

• Lung and liver diseases

A healthcare provider should examine if there is frequent choking while feeding. Early intervention could reduce the risk of aspiration pneumonia and other complications.

What To Do If A Baby Chokes While Breastfeeding?

Take the baby off the nipple instantly and position them upright if you notice them gagging or choking during feeding. This action aids in clearing their airway. Stay calm and seek medical attention if they are frequently coughing or gagging. Don’t worry. It may take some time for your infant to become comfortable with suckling.

Gagging and choking during nursing is common in young babies. Most of the time, babies can protect themselves from breast milk aspiration due to hyper-gag reflex.

The following first aid can be done if your baby chokes while nursing   (4).

• Stop feeding if the baby chokes on milk.

• Hold the baby in an upright position for a few seconds. This could help babies to manage the problem.

• Provide good head and neck support while holding younger infants in an upright position.

• Patting the baby’s back may help them.

If the baby turns blue or becomes unconscious after choking, emergency response is necessary. You should also contact a pediatrician if choking occurs in bottle-fed infants to ensure proper infant safety.

How to Prevent Choking While Breastfeeding?

Dr. Perdomo recommends, “If choking happens during breastfeeding, remove the baby from the breast and allow the forceful letdown to pass before putting them back. If choking happens frequently, moms may try to hand express or use a manual breast pump to express the first part of their milk during the feed, and then put the baby to the breast once the flow slows down.”

The following remedies may help reduce or prevent the incidence of choking on breast milk (1).

• Changing the feeding position is the best way to prevent choking while nursing. The laid-back feeding position is recommended for mothers who have an overactive letdown. This may help slow down milk flow due to gravity, and the baby could manage the flow better.

• You may try to take the baby off the breast for a few minutes during the initial letdown after sucking.

• Lying on the side may also reduce choking incidents. This position may allow the baby to let go of the breast and let the milk flow outside their mouth, to avert choking.

• You may also express milk a few minutes before feeding to reduce overflow and help to control let down.

• It is recommended to seek help from international board-certified lactation consultants (IBCLC) to manage overflow and hyperactive letdown issues. A pediatrician may also help to choose the right bottles and positions to prevent choking while formula feeding.

Note: You should be cautious while expressing or pumping milk since doing it for a longer duration may worsen the outcome. Consult a board-certified lactation consultant who can teach you the correct way to express or pump breast milk.