Breastfeeding and the Sensory World of the Baby
Part II

By Beverly Morgan, IBCLC, Caroline L. Bias, M.S., CCC-SLP, Susan Chick, & Hilary Jacobson, CH.HU.SI.

Sensory Integration and Feeding

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Many times, sensory integration differences show up as feeding challenges. The baby may have difficulties feeding, whether he is breastfed or bottle fed. In some cases, his distress signals are mild and easily missed when he is a newborn. His struggle to integrate sensory messages may go unnoticed because they do not cause problems at first. However, as the baby asserts his preferences, refusal to feed at the breast or at the bottle may result.

Of course, not all feeding problems are due to sensory related issues. The first step to take if you have any feeding related challenges with your breastfed baby is to see an Internationally Board Certified Lactation Consultant. Your IBCLC can help you ascertain exactly what the problem or problem area entails: Perhaps the breastfeeding position triggers one of his sensory integration issues, or his difficulties might not be unrelated to sensory integration at all.
  • If you have a baby who is gagging and upset when he sees the breast, it is possible that he is uncomfortable with something that is happening during the feeding. Perhaps his swallow is not well coordinated and he sometimes feels as though he is choking. This baby may have oral motor issues that make it challenging to master feeding skills, and may require the guidance of a Feeding Therapist.
  • Perhaps he has silent reflux, and is in pain after each feeding. He should see his pediatrician.
  • Perhaps he is intolerant to something in mom’s diet, and is reacting with digestive problems. This can be a trigger for reflux as well. Careful observation by the mother can cue her in to the ‘trigger foods’ which she can then eliminate from her diet. Check in with the baby’s health care provider if the problem continues or worsens for baby.

All of these situations and many others that can’t all be listed here can affect your baby and how he breastfeeds. Here we will focus on sensory integration as it relates to breastfeeding.

How Sensory Integration May Impact Breastfeeding

Touch

Sensitivity to touch varies with each baby. Some babies are super-sensitive over all their body. Others are super-sensitive on only one part of their body. Because breastfeeding is a “high touch” activity, a baby who is touch-sensitive would experience special challenges.

Things to Try:
  • Identify which areas of his body are sensitive to touch.
  • Identify which kind of touch bothers him – firm or light.
  • If baby likes a firm touch, hold him in a firm embrace. Consider swaddling.
  • If baby does not like a light touch, do not stroke him while he is nursing.

Avoid triggering a baby’s touch-sensitivities; do not touch him in his sensitive areas while he is feeding. If baby has a sensitive head, for example, be sure you do not put pressure on his head. Even a blanket or a hat against the skin can be a problem for children who do not like light touch. If he has sensitive feet, avoid any stimulation of his feet while he is nursing.

Light Sensitivity

This baby may be so bothered by light that he sleeps all day to avoid the light. He may be wakened at night by just a small amount of light.

Things to Try:
  • Avoid bright lights.
  • Nurse in a dimly lit room, even at night, while nursing.
  • Shield this nursing baby’s eyes from light, for instance, by using mom’s shirt, or by draping a blanket or towel over mom’s shoulder to create shadow.

Sensitivity to Sound

This baby may be so distracted by sound that he finds it hard to concentrate on breastfeeding. He may sleep through the day when there is a lot of sound, or he may hardly sleep because sound keeps him awake.


Things to Try:
  • Use a quiet room to nurse.
  • White noise such as the sound of a fan may help this baby ignore other sounds.
  • Use a blanket over mom’s shoulder to buffer sound in noisy places.
  • Play soft music in the background.
  • Sing a familiar song or lullaby that baby enjoys while you are getting baby latched and while nursing.

Sense of Smell and Taste

This little one may not want to nurse if mom puts anything with odor on her body. Lanolin on her nipples, soaps, lotion, cream or perfumes on her body, or chlorine from the pool all may cause the baby to fuss rather than nurse. The baby may react to the taste or smell of his mother’s milk much more than his peers. While another child may take differences in the taste of mom’s milk in stride, the smell or taste sensitive baby may not nurse as well at times when the taste or smell of mom’s milk is not as he expects.

Things to Try:
  • Only use lotions, soaps, or perfumes that baby is used to and does not react to.
  • Use caution when changing laundry detergents, deodorants, etc.
  • Be aware of your diet and how different foods, drinks, and medications affect the taste of your milk.

Movement

This baby may need to be kept in motion a specific way. He may cry or fret when the movement is not present. In some cases, he may need to be kept very still. Often this baby cries in alarm and discontinues nursing from slight shifts and movements. It can be difficult to find a position to remain in while baby is nursing.

 Things to Try for Babies who Want to Be Kept Still:
  • Experiment with positioning.
  • Lay baby flat on a pillow with mom dropping her breast into the baby’s mouth.
  • Lay baby on his side on the bed with pillows supporting him and mom.
  • Nurse while the baby is in a sling, to help him feel confined. Mom may need to sit or stand without moving very much, so as not to over-stimulate this movement-sensitive baby.

 Things to Try for Babies who Like Movement:
  • Sitting in a rocking chair while nursing.
  • Swinging in a porch style swing while nursing.
  • Vibrating massage pad under the seated mom for babies who seek constant vibration/movement.
  • Bouncing on an exercise ball

Balance, Body Position

Fear of falling; Uncomfortable sensation when being moved. Often this baby seems distressed by handling, cries when handled, and settles when put down or swaddled.

Things to Try:
  • Swaddling.
  • Holding in a firmer, more secure feeling way.
  • Moving baby to breast more slowly.
  • Slow, careful handling.
  • Keeping the baby’s arms close to his body when moving him.

Interoception

These are the subtle and sometimes not so subtle messages from a baby’s internal organs and body.

Interoception is the communication the baby has with the inside of his own body: what he feels when he needs to urinate or stool, what he feels when he is hungry, or feeling discomfort or pain due to a problem such as GERD-reflux. This baby may want to pause while nursing, or to not initiate breastfeeding at all, while he is tuning in to his internal stimulus and listening to his body.

Things to Try:
  • Become familiar with your baby’s body language.
  • Hold him quietly until you see he has finished his processing.
  • Try not to distract him by talking to him, urging him to nurse, or moving him, unless you see that what you are doing is helpful for him and not distracting.

Finding Answers to Puzzling Behaviors

If your baby has behaviors that puzzle you, getting the answers in a timely manner can help you meet the unique challenges you are facing. Remember, there are no difficult babies; there are only babies who are having difficulties. Granted, it is often bewildering to parent a baby with feeding or with sensory problems, but our babies depend upon us to figure out their problems and to make choices that will help them be more comfortable. It is up to us to aid them as they learn how to “make sense of their senses.”

Helping an infant with sensory issues learn how to interpret sensory information has long range benefits. Any time a baby or child has a successful learning experience, the brain is primed for more positive learning experiences later on in their development.

If you decide that you need professional guidance beyond your IBCLC and health care provider, begin with a call to your IBCLC or you health care provider’s office. Share your concerns and ask for a referral to a specialist. Where available, an Occupational Therapist with infant feeding and sensory processing expertise is usually the best resource for Sensory Integration or Sensory Processing help for your baby. You may also find it helpful to consult a feeding therapist (Occupational Therapist or Speech-Language Pathologist), a Physical therapist, or a Chiropractor if they have experience with infant feeding and sensory needs. Other treatments that may be valuable for your baby include CranioSacral Therapy and Neuro-Developmental Treatment (NDT). It can be difficult to find qualified professionals with all areas of expertise needed so you may have to coordinate between professionals to best meet your baby’s particular needs.

Each type of therapist and each kind of therapy has a different approach. If you or your child does not click with one therapist, keep looking until you find the right chemistry.

Whichever avenue you explore, look for someone with experience working with infants, and someone who is sensitive to babies and respectful of them in their approach. You spend the most time with your baby and know your baby better than anyone.

Resources

How to Locate a Professional

Books

  • Sensory Integration and the Child, by A. Jean Ayres, Learn about sensory integration from the founder of the movement
  • The Out-of-Sync Child a classic book by Carol Kranowitz (and her other books about sensory integration)

Websites