As an Infant Feeding Therapist and lactation informed Occupational Therapist my journey involves delving into the intricate nuances of feeding - supporting both breastfeeding and bottle-feeding mothers and their precious little ones. One of the challenges that often arises during these feeding sessions is the occurrence of clicking sounds – a concern that warrants attention and understanding.
The Clicking Conundrum
What is Clicking?
In order to understand clicking during breast and bottle feeding we must first understand the basic mechanics of clicking! Clicking during feeding is characterized by audible sounds, akin to a clicking or smacking noise, that can occur both during breastfeeding and bottle-feeding. It is essential to recognize that clicking is not a normal part of the feeding process and may indicate an underlying issue that requires investigation. Typically clicking is caused by a loss of suction. Let's delve deeper into this!
Possible Causes:
1. Poor Latch: A clicking sound may be a sign of an ineffective latch, where the baby is not properly attaching to the breast or bottle.
3. Inadequate Suction: Weak suction may result in the clicking sound during feeding.
4. Impaired Oral Motor Skills: improper tongue movement/placement, poor oral awareness, body tension, and oral strength can all attribute to clicking occurrences.
4. Tongue Tie: Tongue tie - a condition where the strip of skin beneath the baby's tongue (lingual frenulum) restricts movement, can contribute to clicking.
**It's important to note here that not all tongue ties are obvious because everyone has a frenulum. It's the relationship between the frenulum and tongue range of motion/ability to reach the roof of the mouth that is important rather than just the appearance. It is further important to note that if you suspect a tongue tie it is imperative to seek out pre-surgical therapy from a therapist that specializes in infant oral motor skills. This provides better outcomes for your little one and can often save you from having to get the surgery.
Addressing Clicking: Tips and Strategies
1. Observe Latch:
For breastfeeding, ensure a deep latch where the baby takes in a significant amount of breast tissue. Their chin should be against your breast, nose free, and an asymmetrical amount of areola should be showing.
For bottle-feeding: Choose a bottle that has a gradual slope to it (Evenflow, Lansinoh, Pigeon, Dr.Browns) and work with a therapist to choose a nipple flow that matches the baby's suck-swallow pattern.
2. Check for Tongue Tie:
If clicking persists, consult with a healthcare provider (ideally someone who specializes in infant oral motor skills) to assess the presence of a tongue tie.
If identified, a simple surgical procedure (frenotomy) paired with oral motor therapy may be recommended to release the tight frenulum. Always work with a post-release therapist that specializes in feeding. Never have this procedure done without seeking follow-up therapy. Babies begin learning to suck in the womb as early as 14 weeks. They have a longstanding poor oral motor pattern that needs to be addressed along with the tie for best outcomes.
3. Assess Bottle and Nipple Type:
For bottle-feeding, experiment with different nipple textures and nipple flows to find one that facilitates a better latch.
Always opt for slow-flow nipples to encourage a paced, coordinated suck-swallow-breath rhythm. You do not need to increase the nipple flow as baby ages - this is largely a marketing scheme.
4. Engage in Responsive Paced Feeding:
Pay attention to your baby's hunger cues and initiate feeding before signs of frustration or distress appear.
Allow breaks during feeding to promote a more relaxed and coordinated feeding experience.
If bottle feeding, initiate feeding in elevated side-lying with the bottle horizontal to the floor. Only allow the nipple to fill half-way to promote proper sucking pattern and oral motor skill development.
Seeking Professional Guidance
Persistent clicking warrants professional evaluation by an infant feeding therapist or IBCLC (International Board Certified Lactation Consultant). As experts, we can provide personalized guidance, conduct thorough assessments, and tailor interventions to address the specific needs of both mother and baby.
Clicking during breastfeeding or bottle-feeding can be a source of concern for parents, but with informed guidance and timely interventions, it's often a challenge that can be overcome. By recognizing the potential causes and implementing strategies to promote a harmonious feeding experience, both you and your baby can enjoy the nourishing bond that feeding provides. Remember, seeking professional support is a proactive step toward ensuring a positive feeding journey for both you and your little one.
If you would like help assessing or treating your baby's clicking please reach-out for an in-person or remote therapy session with Hali'a Therapeutics! We can help guide you to improve your feeding experience and calm your nerves.
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