Sucking during breast feeding uses more muscle strength than sucking from a bottle.

 A baby should have a rhythmic suck-swallow-breath pattern and generally have a similar number of sucks in between each swallow.  The typical number is 3-5 sucks then a swallow.  If a baby is taking too many sucks before breathing, he can become short of breath.  Typically they will do many sucks, swallow, and coordinate breathing through out.

 You can try to help establish a rhythm by rocking while feeding.  The baby may start to time its suck-swallow-breath pattern to the rocking rhythm

 A baby’s latch onto a nipple or bottle is not dependent on the lips, rather it is achieved by the tongue.  The tongue should curl tightly around the nipple.  The jaw comes down noticeably with a good suck which creates negative pressure and the tongue makes a wave type of motion forward and backward in the mouth. 

 Signs of problems with sucking:

• Too small jaw movements – not creating enough negative pressure.
• Too large jaw movements – breaking the seal that the tongue has on the nipple
• Losing a lot of liquid out of the mouth – the tongue is not maintaining its seal
• A clicking sound during sucking – the tongue is moving so strongly that it is clicking and losing its seal
• Taking longer than 30 minutes to drink a bottle
• Breathing heavily or gasping for breath after drinking – means he is not pausing for breaths during sucks
• Choking or coughing on the milk
• Extending away from the nipple, trying to get away from it – this is a defense and you need to listen to it

 Noticing some of these problems may mean that you need to talk to your doctor and get a referral for Occupational Therapy.

 There are some techniques that a therapist can teach you to make it easier.

• If the child is not pausing for breath and is then breathing heavy or panting, then you need to count the sucks and create a breathing break after about 5 sucks.  You can do this by taking away the food every 5 sucks.  If nursing, you have to break the seal with your finger.  If bottle feeding, you can lower the bottle so that the food is not coming out, or you can take it out of the mouth.
• If the baby’s jaw movements are not big enough or too big, you can use some jaw control techniques.  These techniques just give a little pressure to the jaw and cheeks to give some stabilization.  They are not meant to actually control what the jaw is doing, only to help the child control it themselves.
  • One technique is to squeeze the cheeks in a bit.  This decreases the space in the mouth so it makes the suction easier.
  • Another technique is slight pressure from the chin back and up into the jaw.  This is just to provide stabilization, and you don’t want to hold the jaw closed or open.

 You can use one, two, or three fingers, and it takes a lot of practice to be able to do these techniques properly.  Please use the guidance of your O.T. in order to assure that you are doing it right.