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Feeding Difficulties in Newborns

 
  Source: Article by the Department of Neonatal and Developmental Medicine, Singapore General Hospital (SGH), a member of the SingHealth group.   
     
 

The majority of babies suckle well soon after birth. Nevertheless, some babies feed with varying degrees of difficulty or take an extremely long time (over an hour) to finish a feed.

There are many reasons your baby may be feeding poorly

If you are breastfeeding, your baby should be able to latch onto your areola firmly in order to stimulate your letdown reflex. The letdown reflex makes your milk available to your baby by propelling it into the ducts and the nipple.

If your letdown reflex is inhibited, nursing in a quiet room surrounded by pictures of your baby or the smell of his or her clothes may help to develop the reflex. Consult your doctor or lactation nurse if you can’t get your baby to latch on. You may wish to consider “rooming-in” with your baby to bolster your confidence and develop better breastfeeding skills.

Why is my baby not feeding well?

  • Some babies feed poorly because their mouths are sore. This can be due to thrush, a fungal infection that appears as white patches or plaques on the tongue, inside of the cheeks, roof of the mouth or the lips. Consult your doctor if you see white patches in your baby’s mouth. Thrush may be treated with an anti-fungal gel that is best applied on the affected area after each feed. 
  • Mouth ulcers may be another cause of difficult feeding and will usually heal spontaneously.
  • A few babies are born with a gap in the roof of the mouth called a cleft palate. This is easily seen when your baby opens his or her mouth wide or is crying. A cleft palate may cause milk to enter the nose passages when your baby is trying to suckle and cause choking. Consult your doctor immediately if you detect a cleft palate.
  • Babies who are born prematurely may find it difficult to coordinate the ‘suck-swallow-breathe’ actions. This will improve as the baby gets older and with more feedings. Your lactation nurse may advise you to limit the number of suckling at each feed, so that your baby can catch his or her breath in between suckling and not be tired.

What other signs should I look out for?

If your baby does not feed well or looks ill, consult your doctor immediately. Signs of illness include fever, lethargy, drowsiness or excessive sleepiness, rapid breathing, times where the baby stops breathing, cough, turning ‘off-color’ or purplish-blue in the lips or tongue.

Other signs that your baby needs urgent medical attention include persistent vomiting, tummy distension and inability to pass urine for 24 hours. 

Also, if the baby has an infection, he or she will need to be carefully examined by a doctor and a stay in hospital may be needed for further tests and treatment.

Article contributed by the Department of Neonatal and Developmental Medicine at:

 Singapore General Hospital (SGH)

Ref: W09

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