1. Any trauma during birth – forceps, vaccum, marks, bruises

2. Torticollis – head asyymettry

3. Breech delivery

4. Flattened ear

5. Closed lip during sleep

6. Cranial moulding due to long labor

7. Facial abnormalities

8. Lip seal

9. Tongue tie

10. Low muscle tone of cheeks

11. Receding chin

12. High arched pallet

13. Cleft palette

14. Long periods of intubation creates grooves ij palette, narrow arched palette

15. Small nasal passage

16. Shallow gag reflex – oral exercise, sensitive feeding method

17. Fetal intrauterine position in stomach

 

How To Resolve It?

1. Try different position on one breast

2. Therapeutic exercise to strengthen lip tone (tapping stretching, stroking) – orbicularis oris kiscle around lips before feeding

3. Use finger, or pacifier with round shaped nipple – play tug of war

4. For palette issues – 60 degree feeding

5. For Receding chin – head tilted back

6. For Tongue tie – Tongue tip elevation, Nipple shield

7. For Small nasal passage – release breast frequently to pace feeds, remove intense part of milk to save high flow

The above steps are to be assessed by an experienced lactation counsellor or IBCLC if a pathology is found.