What to do when your baby can’t latch on one side

When your baby has a shallow or painful latch on only one side, it can be very confusing for parents. Sometimes a baby will initially latch on the more difficult side but pull off quickly or keep turning their head and unlatching. Some moms will notice compression of the nipple of a “lipstick-shaped nipple” on only one side. It would seem that if a baby can latch well on the right side, they should also be able to do that on the left side. What gives?

Click here for my free guide to baby-led latching.

What causes a painful latch only on one side?

Most parents initially believe that if a baby is struggling to latch onto one breast it is due to the size or the shape of the nipple or the flow of the milk on that breast. Although these two factors can contribute in some cases most of the time the leading factor is BODY TENSION.

What is body tension and how does it affect breastfeeding?

The first thing we have to remember is that breastfeeding is full-body activity and what is happening elsewhere in the body impacts how a baby latches to the breast.

In my practice, what I found to be the driving force behind these difficulties with the consistency of latching from one side to the other is body tension. So often, babies retain tension patterns present in utero aka when you were pregnant.

For example, your baby may have been in a position in your womb where their head was turning towards the left side, and now they always seem to prefer to turn their head to the left side. Preferences in position and tension patterns impact how they latch onto the breast and make one breast easier for them to latch onto than the other.

How torticollis affects breastfeeding

One type of body tension that can occur in infants and impact breastfeeding is torticollis. Congenital muscular torticollis is a shortening of the sternocleidomastoid muscle or SCM and is likely from the restricted intrauterine position. Torticollis can range from mild to severe and can impact the baby's suck and ability to latch.

According to Cathy Genna Watson IBCLC and author of Supporting Sucking Skills, “The twisted head position causes the baby to repeatedly roll away from full lip and chin contact with the breast and can be frustrating for both mother and infant.”

Difficulty latching on one breast
Head turning preference
Head tilting to own side
Difficulty opening mouth wide
Difficulty extending chin into the breast to latch
Baby seems very stiff in their neck and shoulders
Baby HATING tummy time
Baby only being able to latch in very specific positions

What can you do about your baby’s body tension to help with breastfeeding?

Breastfeeding can feel like a group sport, at times. If your baby is having latching difficulties, I can’t recommend enough establishing care with an international board-certified lactation consultant, IBCLC for short. This provider can be your point person for helping identify patterns and evaluate tension in your baby. They can further help by referring you to a provider that specializes in bodywork.

Providers that specialize in recognizing and treating body tension:

Each of these specialists can treat and identify tension patterns that were formed in utero. By releasing some of that tension you can help the baby be able to latch on both sides comfortably and leading to an overall easier breastfeeding journey for you both.

Which one of these providers will be right for my baby?

The IBCLC you are working with should be able to refer you to the provider in your area with the most experience working with breastfeeding infants. Share with the bodywork provider what your breastfeeding concerns are so they can target therapy to help improve challenges.

Positioning help if your baby can only latch on well to one breast

Our number one goal is to help your baby be able to move their body with ease so they can breastfeed comfortably in a variety of positions. As you are working with a bodyworker you can support your baby by feeding in positions that maintain the preferred head position. For example, If your baby can only latch in a cross cradle position on the LEFT try latching them in football on the RIGHT. This allows the baby's body to stay in the same position so latching can be easier.

You may need to experiment with different positions to find the one that works the best for you and your baby.

According to Cathy Genna Watson, “Creative positioning may be required when an infant has structural differences from a restricted intrauterine environment. Torticollis is frequently under-recognized and any alteration in neck mobility or facial symmetry should be brought to the attention of the infant's healthcare provider.”

In my clinical experience, many providers take a “wait and watch” approach to neck mobility or torticollis concerns. I would encourage you as the parent to ask for a referral to a pediatric PT to evaluate your baby and start on a treatment plan early. \
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Are there things I can do at home to help with my baby’s boob preference?

Absolutely!

Start by encouraging your baby to turn to the non-preferred side, and place toys, mirrors, or smiling faces to draw the baby's attention.
Switch up how you place the baby in the crib so they have to turn their head in the non-preferred direction to look at you!
Limit time in the swaddle. A swaddle is a great tool but we also want to encourage LOTS of free movement as well. The goal is to equal time in and out of the swaddle in 24 hours.
Limit time in containers. Baby containers like bouncers/seats/swings are sometimes helpful, but we want to balance this with free movement on the floor so the baby can kick, squirm, and integrate their reflexes.
Babywearing is a wonderful way to help your baby get more comfortable in their body! As babies get older they will naturally become so curious about the world around them and turn to see all the exciting new things!

Rhythmic movements can be so helpful for babies who are tight, tense, and fussy. They can help loosen tight muscles, calm the nervous system , and help integrate reflexes here is a quick demonstration from IBCLC Bryna Sampey.

Tummy time. Okay so I guess your baby is NOT a huge fan but we want to focus on short bursts of tummy time throughout the day - REMEMBER THERE SHOULD BE NO CRYING IN TUMMY TIME.

I am a huge fan of Michelle Emanuel’s tummy time method which focuses on short bursts of quality tummy time throughout the day focused on the parent-child connection. You can find a list of tummy-time certified professionals here.

Key takeaways

If your baby is struggling with latching on one breast more than the other or one latch on the breast is pinchy or painful, look into tension. In the short term adjust your latching position to keep the baby in their preferred head position and reach out for support from an IBCLC as you find which bodywork provider is the best fit for you in your community. If you notice a head-turning preference or a flat spot on your baby’s head, reach out to your pediatrician for a referral to a pediatric physical therapist.

In addition to the hands-on therapy your baby gets from their bodyworker incorporating lots of free movement at home is key. What we do in between appointments MATTERS! So finding ways to incorporate rhythmic movement or tummy time with your little one can have a direct impact on how they are able to latch.

If you can’t find an IBCLC who you like and trust then working with someone virtually can be HUGELY helpful. Our team does offer virtual consultations and you can find more information here.

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Cheering you on, always!!

XOXO

Kelly

Boob School Founder and CEO

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