Lopsided nursing - did this happen to you?

[citymama]

I know I can't be alone in this one. DD2 has a strong preference for one breast over the other - so much so that she will pull off a minute or so after nursing on the less-preferred side, until I switch her. So of course, the favored boob (aka FB) produces more milk and is bigger as the other! :eek: (It's not obvious with my clothes on, so don't go thinking I look like a freak. ;)) Really, my concern is that the "neglected" boob (aka NB) is dropping in supply, and also that DD2 doesn't want to nurse from it as much. I remember with DD1, she also preferred this breast (it must make more milk! and it's a tad bit bigger than the other to begin with) but she nursed happily from both sides. I do make sure to offer both breasts each time, but I think part of the problem is me - I'm right handed and automatically offer the left breast if I can't recall which side I last nursed her from.

When I pump, FB produced twice as much milk as NB, and it definitely fills up with milk more quickly overnight and gets way more engorged - so it's the breast I tend to offer more. Funnily enough, let down is much quicker with NB than FB.

Anyway, I'm wondering if anyone has experienced this and what strategies/tricks you would suggest to make both sides equally preferred, and of course, to maintain supply. (I know, I know, I should be pumping more on the less preferred side.) Thanks!

[brittone2]

My kids have all had a preferred side.

If she's really, really strongly preferring one side, one thing I'd mentally rule out is torticolllis. Just because that strong preference can be a bit of a flag for it. Just something to keep an eye on and it can be tough to catch in babies because they are awesome at compensating (hiking shoulder up, turning body vs. just their head, etc. Probably not the cause but something I'd look at in my own kids if they had a really strong preference.

If she's sleeping or something can you sub non preferred boob at that time when she's feeling less picky? ;)

[BabbyO]

I had a similar situation when DS was a newborn. He'd only nurse on one side at a time, so one side would always be uncomfortable for me. I actually asked the doc about it and he said it was not abnormal...he even mentioned that some kids he saw would only nurse from the right or left side.

He recommended pumping the "other" side when nursing. It helped alleviate fullness, kept my supply up, and gave me a jump start on my frozen supply for when I was at work.

I did it and it worked. Eventually, when DS was a bit older he was willing to transition from one side to the other during nursing sessions.

You could try pumping. It would at least keep your supply up. Maybe your LO will transition after a while...or maybe he will always have a FB.

[citymama]

My kids have all had a preferred side.

If she's really, really strongly preferring one side, one thing I'd mentally rule out is torticolllis. Just because that strong preference can be a bit of a flag for it. Just something to keep an eye on and it can be tough to catch in babies because they are awesome at compensating (hiking shoulder up, turning body vs. just their head, etc. Probably not the cause but something I'd look at in my own kids if they had a really strong preference.

If she's sleeping or something can you sub non preferred boob at that time when she's feeling less picky? ;)

I'm pretty sure there's no torticollis since she's 5.5 months now and able to hold herself up well and no tilt any more. When she was 1-3 months, she would tilt her head slightly to her right (when you're looking at her, it would be to your left). Would that correspond with a preference for mom's left breast? I can't quite connect the dots together but since you're a PT maybe you will be able to! Thanks for flagging that.

I think it is something more simple, like one nipple and breast being larger and also my own preference to hold her in the crook of my left arm rather than right. I used a nursing pillow with DD1, which I think contributed to my nursing being more even on both sides. So I think it's both her and me. BabbyO, good suggestions about pumping on the other side to boost supply. Thanks so much, to both of you.

[brittone2]

I'm pretty sure there's no torticollis since she's 5.5 months now and able to hold herself up well and no tilt any more. When she was 1-3 months, she would tilt her head slightly to her right (when you're looking at her, it would be to your left). Would that correspond with a preference for mom's left breast? I can't quite connect the dots together but since you're a PT maybe you will be able to! Thanks for flagging that.

I think it is something more simple, like one nipple and breast being larger and also my own preference to hold her in the crook of my left arm rather than right. I used a nursing pillow with DD1, which I think contributed to my nursing being more even on both sides. So I think it's both her and me. BabbyO, good suggestions about pumping on the other side to boost supply. Thanks so much, to both of you.

MIght be worth a look. The sternocleidomastoid muscle is the one that is usually involved with tort. If they tip to the right (sidebending ear right ear toward right shoulder), then their head usually also rotates a bit toward the left. So tight SCM muscle on the right=head will tilt a bit to the right with chin rotated to the left a bit. Since she did tip a bit in the past I'd rule that out just in case. Many, many peds miss tort because babies are fantastic at compensating and unless you know how to isolate the movements at each joint, it can easily be missed (baby doesn't appear to tilt head because they hike up the shoulder on that side for example).

eta: whoops. If she's rotated toward the left side she would probably (??) prefer the right breast, but it is possible that it could still be impacting her, especially since she did have some tipping to start with. And really when you are BFing they aren't rotating their head, their head and shoulders are both facing you, kwim? So the rotation may not matter that much but she might be slightly less comfy (or was slightly less comfy) if her right SCM was tight.

[citymama]

MIght be worth a look. The sternocleidomastoid muscle is the one that is usually involved with tort. If they tip to the right (sidebending ear right ear toward right shoulder), then their head usually also rotates a bit toward the left. So tight SCM muscle on the right=head will tilt a bit to the right with chin rotated to the left a bit. Since she did tip a bit in the past I'd rule that out just in case. Many, many peds miss tort because babies are fantastic at compensating and unless you know how to isolate the movements at each joint, it can easily be missed (baby doesn't appear to tilt head because they hike up the shoulder on that side for example).

eta: whoops. If she's rotated toward the left side she would probably (??) prefer the right breast, but it is possible that it could still be impacting her, especially since she did have some tipping to start with. And really when you are BFing they aren't rotating their head, their head and shoulders are both facing you, kwim? So the rotation may not matter that much but she might be slightly less comfy (or was slightly less comfy) if her right SCM was tight.

Whoops on my part. OK, let's start over. She actually tilts her head towards her left. And prefers my left breast. So it is actually the same tilt going on - I checked and it is the same side that is stretching out when sitting and when nursing on the left side. Sorry about the confusion.

So you are right that there is a slight tilt factor coming in to play. To be honest, when you look at her you don't notice it at all except if she's tired. Her head and neck control is excellent. So, do we still need to be concerned about torticollis? What does it mean if she does have a mild case at this age? Does it need to be treated, or are there home PT steps we can take to help reduce it? Her tilt is much much less than it used to be, and she seems comfortable moving her head in any direction she needs to.

Thanks so much for the advice!

[egoldber]

This can also happen with kids with reflux. Their reflux gets aggravated by lying on one side or the other. My younger DD definitely preferred my left side and I always got more pumping from that side. Not sure of that was a chicken-egg thing though. :)

[brittone2]

Whoops on my part. OK, let's start over. She actually tilts her head towards her left. And prefers my left breast. So it is actually the same tilt going on - I checked and it is the same side that is stretching out when sitting and when nursing on the left side. Sorry about the confusion.

So you are right that there is a slight tilt factor coming in to play. To be honest, when you look at her you don't notice it at all except if she's tired. Her head and neck control is excellent. So, do we still need to be concerned about torticollis? What does it mean if she does have a mild case at this age? Does it need to be treated, or are there home PT steps we can take to help reduce it? Her tilt is much much less than it used to be, and she seems comfortable moving her head in any direction she needs to.

Thanks so much for the advice!

I would have someone take a look. She may be outgrowing it, but babies are awesome at compensating. So they may rotate their trunk a little more instead of just rotating their head at their neck, kwim? They hike a shoulder a bit which makes it look like they aren't as tilted. Stuff like that is really hard to tease out unless you know how to check range of motion at each joint in isolation (and make sure the baby isn't moving anywhere else, like torso/trunk).

Even when tort resolves pretty well it isn't uncommon to see some tipping start back up if they are overtired, sick, go through a growth spurt, etc.

However, I would have someone take a look. She may still have that breast preference because there's more tightness than may be readily apparent. She may have developed it when things were tight and now it is just kind of ingrained.

When one side is tight, the opposite side also tends to get weak as it is kind of overstretched most of the time. So some babies need to work on strengthening the opposite side.

It can impact their gross motor skills if untreated (sitting is hard if they are tipping because those baby heads are huge and heavy ;) and it can throw their balance off). Some babies also end up with a little plagio (flattening) partially caused by the tort.

There are stretches and strengthening exercises that can work but I wouldn't feel comfortable suggesting them online. You can definitely do no harm by working on positioning so she has to rotate her head to the non preferred side to see whatever is interesting in the room.

Many, many peds miss tort unless it is a super obvious case. It may be worth talking with a PT from EI and or a private practice PT to see if they can give you a home exercise program, and of course tell you if you even need it for your DD.

I'm not sure if that helps. 1/3 of my caseload at one practice were tort cases. It is one of those things that usually responds well to treatment with exercise/stretching/strengthening. There are even ways you can carry her to help strengthen the opposite side if necessary.

[Beth24]

So ironic that I was reading this thread yesterday and today at our 4 month appointment our ped noticed a very slight left tilt and thinks our baby has a mild case of torticollis. She wants me to call a PT and learn some stretching exercises. My baby doesn't prefer nursing on one side but my "better" boob is the right one-- it just has more milk and is bigger. Anyways, just thought I'd mention that it's def worth checking out.

[MamaSnoo]

I t is not really relevant to the torticollis discussion (sounds like you have had a lot of good advice already there), but I have a GF whose baby refused one breast to the point that she lost her supply on that side when the baby was 2 mos old. She nursed and pumped on one side only for several months after that, and I think she weaned around 9 mos. Not that it is your ideal outcome, but you can still have a positive breastfeeding relationship just nursing on one side.

I am pretty sure I have seen posts from a mama on here who did that as well, but I do not remember for sure.