There’s nothing quite like the feeling of your baby successfully latching for the first time after you’ve given birth. Perhaps the only thing that tops that feeling is the euphoric tingling feeling you get once your milk lets down for the first time — thanks, oxytocin. However, some new parents experience a jolt of something unexpected in those first nursing sessions — their newborn baby coughing or choking on breast milk.
If you’re noticing your newborn choking while breastfeeding, it’s understandable that you might feel extremely worried or feel like something might be wrong. However, it’s likely that the issue is resolvable and is not indicative of any major issues. These tips and tricks will help your newborn stop coughing while breastfeeding so everyone can enjoy this lovely bonding experience for what it’s supposed to be.
Why is my baby coughing while breastfeeding?
One of the most common reasons babies choke on breast milk is oversupply, says Leigh Anne O’Connor, an international board-certified lactation consultant. A “fast let down,” or forceful letdown can also sometimes cause newborns to cough or seem to choke on breast milk, says Deedee Franke, a registered nurse and international board-certified lactation consultant. A forceful letdown and oversupply are common breastfeeding issues and often go hand-in-hand.
What is oversupply?
When you make more milk than a baby needs, this is considered an oversupply. Other than noticing that your baby coughs or gags while breastfeeding, other signs you may have oversupply include the baby clamping down on your nipple to stop the rapid flow of milk. Ouch. A forceful letdown is when your milk comes out too fast and forcefully.
Babies can choke on breastmilk, but “babies have a strong gag reflex so they can typically manage the flow by coughing and by pulling off your breast,” O’Connor says. Although it’s not dangerous, seeing your baby cough, gag or pull away from your breast can be pretty scary or even a bit painful, so it’s important to figure out ways to prevent newborn choking while breastfeeding.
How to keep a newborn from choking while breastfeeding
There are a couple of ways to help with struggles associated with oversupply and forceful letdown, according to Franke. First, try simply changing up your breastfeeding position. A laid back position or a side-lying breastfeeding position may be more successful and comfortable for baby if you have a forceful letdown.
A laid back breastfeeding position is pretty self-explanatory, in that you literally lay back a bit while nursing your baby. You want to find a way to be in a slightly reclined position to feed your baby, and this can be done leaning against a partner or using a reclining chair. If you want to try the side-lying breastfeeding position, you’ll need a flat surface to lay on, whether it’s a bed, a large couch, or even the floor. Laying on your side, keep your head and back in a straight line, and put your head on your pillow or cradled in your arm. Place baby on their side, facing you, and guide your nipple into the baby's mouth.
And if you have an oversupply or fast letdown, O’Connor says you can anticipate this by hand expressing a small amount of milk just before your baby latches to release the “initial blast of breastmilk.”
Signs you have a forceful letdown or oversupply of milk
It can be somewhat challenging to know for sure if you have a true oversupply issue or forceful letdown. But, baby coughing or choking while breastfeeding can indicate oversupply, and you can watch for other indicators, like “pulling down or away from breasts, milk leaking from the baby’s mouth or the baby wiggling or startle prior to coughing — coughing is the last sign,” says Franke. O’Connor adds your baby may even get wide-eyed and stop nursing if your breast milk is flowing too fast for them.
If your newborn is coughing while breastfeeding, try not to worry, Franke says. Over time, your breast milk flow and production will regulate to meet your baby’s needs more precisely and your baby will likely get better at transferring milk, too. Otherwise, try changing up your nursing position and hand-express your breasts before latching. And, if the issue does not resolve, it may be helpful to make an appointment with a lactation consultant who can offer further guidance and support.
Leigh Anne O’Connor, international board-certified lactation consultant
Deedee Franke, registered nurse and international board-certified lactation consultant