Baby Choking On Breastmilk: Why Does It Happen And What To Do

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If you see your baby choking on breastmilk, it could be because their swallowing skills aren’t fully developed. Choking when breastfeeding can result in innocuous coughing. Further, milk can sometimes make its way into the lungs, causing aspiration pneumonia (1).

If your baby has rapid breathing, turns blue, or becomes unconscious from choking on breast milk, get emergency medical attention. If your baby has experienced many choking incidents, you might want to see a pediatrician.

Read on to learn more about the reasons for choking in babies, preventive measures, and what to do if you find yourself in this scenario.

Why Does A Baby Choke While Breastfeeding?

A baby can choke on breastmilk due to various reasons ranging from normal immature swallowing to feeding problems due to anatomical or functional disorders. It can also be due to maternal factors.

The main causes of choking while breastfeeding can be (2):

  • Oversupply of breast milk: Faster milk flow is one of the major causes of choking on breast milk. Infants may not be able to swallow quickly. This may often happen if the mother has an oversupply of breast milk. The baby may bite while breastfeeding due to the overflow of milk, thus making swallowing further difficult.
  • Overactive letdown: It is the forceful ejection of milk when your baby is sucking. Let down reflex is controlled by oxytocin hormones. Increased release of breast milk can cause gulping, coughing, or choking in infants.

Infants who have feeding difficulties are associated with a high risk of choking while breastfeeding or bottle-feeding. The following congenital abnormalities may result in feeding problems (3)
.

  • Developmental delay
  • Neurological issues such as cerebral palsy
  • Down’s syndrome
  • Structural anomalies of oral, respiratory, or feeding structures, such as cleft lip and palate and Pierre Robin syndrome
  • Gastrointestinal issues, such as tracheoesophageal fistula
  • Congenital heart diseases
  • Lung and liver diseases

A healthcare provider should examine if there is frequent choking while feeding. Early intervention could reduce the risk of aspiration pneumonia and other complications.

What To Do If A Baby Chokes While Breastfeeding?

Gagging and choking during nursing is common in young babies. Most of the time, babies can protect themselves from aspiration due to hyper-gag reflex.

The following can be done if your baby chokes while nursing (4).

  • Stop feeding if the baby chokes on milk.
  • Hold the baby in an upright position for a few seconds. This could help babies to manage the problem.
  • Provide good head and neck support while holding younger infants in an upright position.
  • Patting the baby’s back may help them.

If the baby turns blue or becomes unconscious after choking, seek emergency medical care. You should also contact a pediatrician if choking occurs in bottle-fed infants.

How to Prevent Choking While Breastfeeding?

The following remedies may help reduce or prevent the incidence of choking on breast milk (1).

  • Changing the feeding position is the best way to prevent choking while nursing. The laid-back feeding position is recommended for mothers who have an overactive letdown. This may help slow down milk flow due to gravity, and the baby could manage the flow better.
  • You may try to take the baby off the breast for a few minutes during the initial letdown after sucking.
  • Lying on the side may also reduce choking incidents. This position may allow the baby to let go of the breast and let the milk flow outside their mouth, to avert choking.
  • You may also express milk a few minutes before feeding to reduce overflow and help to control let down.
  • It is recommended to seek help from international board-certified lactation consultants (IBCLC) to manage overflow and hyperactive letdown issues. A pediatrician may also help to choose the right bottles and positions to prevent choking while formula feeding.

Note: You should be cautious while expressing or pumping milk since doing it for a longer duration may worsen the outcome. Consult a board-certified lactation consultant who can teach you the correct way to express or pump breast milk.

Frequently Asked Questions

1. Can babies choke on milk while sleeping on their backs?

No. The common belief that babies may choke while sleeping on their backs is false. Your baby’s gag reflex and airway anatomy prevent them from choking and enable them to sleep comfortably (5).

2. Can reflux cause babies to choke?

Yes, since some food and stomach acid travel back to the food pipe during reflux, it may cause babies to choke. However, the condition does not cause any worry as long as your baby is healthy. Further, sleeping on the back may help babies with reflux (6) (5).

If you are worried about your baby choking on breastmilk, you must understand that the feeding skills of babies improve as they grow older. It is improbable for older babies to choke while nursing as they should be well acquainted with the procedure by now. However, if your little one lacks the age-appropriate ability to suck and swallow milk efficiently, they may be facing feeding difficulties. In such situations, you must consult your baby’s pediatrician to understand ways to avoid this problem and evaluate how to manage the situation.

Infographic: Baby Choking: Signs Your Baby Needs Help

Choking often occurs if your nursing infant swallows more milk at once. However, knowing the abnormal signs and when to take medical assistance can help prevent complications. Read through the infographic below to learn the signs you need to get your baby evaluated for choking.

when to seek medical help for a baby’s choking [infographic]
Illustration: MomJunction Design Team

Key Pointers

  • Feeding difficulties, oversupply, and overactive letdown can cause the babies to choke on breastmilk.
  • It is recommended to stop feeding and keep the baby in an upright position immediately when they choke while feeding.
  • You may change feeding position, manage oversupply, or express milk before feeding to reduce choking while nursing.

References:

MomJunction's articles are written after analyzing the research works of expert authors and institutions. Our references consist of resources established by authorities in their respective fields. You can learn more about the authenticity of the information we present in our editorial policy.
1. Aspiration pneumonia; U.S. National Library of Medicine
2. Oversupply; La Leche League International (LLLI)
3. Choking On Milk; My Health; The Government of Malaysia
4. Infant choking while breastfeeding; New Kids-center
5. How to Keep Your Sleeping Baby Safe: AAP Policy Explained; Healthy children; AAP
6. Breastfeeding challenges; NHS
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Dr Bisny T. Joseph

Dr. Bisny T. Joseph is a Georgian Board-certified physician. She has completed her professional graduate degree as a medical doctor from Tbilisi State Medical University, Georgia. She has 3+ years of experience in various sectors of medical affairs as a physician, medical reviewer, medical writer, health coach, and Q&A expert. Her interest in digital medical education and patient education made... more

Rebecca Koyf

(IBCLC, CLC)
Rebecca Koyf is an International Board Certified Lactation Consultant (IBCLC), Registered Lactation Consultant (RLC),Certified Lactation Counselor (CLC) and a LaLeche League volunteer. She has a Bachelor's degree in Accounting and worked as an Auditor for the NYC Comptroller’s Office for 8 years. Her own breastfeeding struggles made her change her career and pursue the field in lactation. She has her... more