Babies who nurse much better on one side than the other are a fairly common thing we see in our practice. These babies are often referred to us by lactation consultants. You might be wondering why on earth you should see a physiotherapist for this issue. The answer lies in the “why” behind the problem.
Feeding poorly on one side can cause all kinds of issues such as difficulty gaining weight, engorgement, eventual decreased supply on that side, and in some cases severe mastitis. On the surface the cause may seem obvious – difficulty latching – and yet the baby latches just fine on the “good” side, so what is the underlying problem?
The true issue is asymmetry in the child’s body. When there are obvious differences in feeding on one side versus the other it’s because the baby is struggling to get their body in the right position to come at the nipple in the correct orientation. While we may think of latching as something that is done with the mouth, it actually involves the entire body. The torso and neck have to be able to get into a particular position in order for the mouth to arrive in the right place at the right angle.
Also, once they get into the right place, there needs to be freedom of movement of the mouth, tongue, and swallowing mechanism in order to suck and swallow properly. To demonstrate how positioning can affect this, try this experiment. Turn your head as far as you can to one side and then try swallowing. It’s difficult, isn’t it? In fact, it may even be slightly painful.
You may be thinking, “But my baby doesn’t have to turn their head as far as I just did to feed”. While that is true, they can have just as much tension as you just experienced with lesser degrees of neck rotation. Let me explain why.
As I mentioned above, babies who have difficulty feeding on one side have asymmetry in their bodies. They are often what I affectionately refer to as “banana babies”. By this I mean that when they lie on their backs their bodies are slightly curved like a banana. The short side of the banana is the left side (don’t ask me why it’s never the right, I haven’t figured that one out yet) and this will be absolutely consistent. They may squirm around into a straighter position but they will always come back into the left banana position as their default. This is because there is tightness and tension in their whole left side. This involves tightness in the left hip and thigh (and can sometimes extend all the way to the foot), the left side of the trunk, and up into the left shoulder and neck.
Due to this tension, you may notice that your baby keeps their head turned to the right side most of the time. This condition is known as torticollis and is caused by this tightness that limits motion. Click here for more information on this.
You may also notice things like the baby’s arm (one or sometimes both) constantly getting in the way on the side where you are having difficulty feeding. This happens due to the tension in the one side that extends up into the arm, preventing the movement they require to get the arm out of the way.
Banana babies are also often colicky, or if not outright colicky, they may appear to struggle to pass gas or stool. Sometimes they wake up in the night crying and once you help them pass gas they go back to sleep. This is due to the tension that actually extends into the supportive tissue of the abdominal and pelvic organs including the intestines. And yes, this means that colic is absolutely treatable. Click here for more on this.
You may be wondering where all this tension comes from in the first place. Since babies are born this way, there is likely something happening in utero. It may be related to positioning as sometimes banana babies have a history of having settled primarily into one position during the pregnancy, but this is not always the case.
Regardless of the cause, one thing we do know is that this is absolutely fixable. With some gentle hands-on treatment, we can release all of this problematic tension and restore symmetry to your baby’s body. Once symmetry is restored then the true underlying cause of the issue has been addressed and everything will improve. The sooner we get to this the better for everyone, so if you have any doubts bring your baby in to see us as soon as possible. Besides, newborns are totally adorable.