Is baby's suck too weak or too strong?

Are you concerned that your baby's suck might be too weak?

There's no evidence to suggest that the musculature of some babies mouths or their suck is innately 'weak' or less competent (as long as baby isn't born prematurely, and doesn't have a diagnosed medical condition like cleft palate or a neurological disorder).

When oral vacuums or pressures are measured in breastfeeding babies, researchers have found a wide range of normal variation in oral vacuums during breastfeeding in babies who were born at term (that is, not born prematurely), and who aren't causing their mothers nipple pain. Some babies have a peak vacuum that is twice that of other babies, all of whom are breastfeeding normally.

In well term babies, it's not the muscular effort of the suck, but the presence or absence of breast tissue drag inside baby's mouth which determines how effective a baby's suck is.

You can find out more about how babies suck here, and about the tongue and its movements here.

Are you concerned that your baby's suck might be too strong?

Sometimes women tell me they are worried that their baby's suck is too strong, and that it is causing them pain.

It is true that researchers have found that the babies of breastfeeding women with nipple pain have peak oral vacuums that are higher than the normal range.

However, sucking is contextual. If that baby is experiencing nipple and breast tissue drag, he'll be reflexly generating higher vacuums to try to hold the breast tissue and draw it into his mouth better. In my view, the higher peak vacuums linked with nipple pain is due to the (unidentified and untreated) nipple and breast tissue drag.

Selected references

Geddes DT, Kent JC, Mitoulas LR, Hartmann PE. Tongue movement and intra-oral vacuum in breastfeeding infants. Early Hum Dev. 2008;84(7):471-477. doi:10.1016/j.earlhumdev.2007.12.008

McClellan HI, Geddes DT, Kent JC, Garbin CP, Mitoulas LR, Hartmann PE. Infants of mothers with persistent nipple pain exert strong sucking vacuums. Acta Paediatrica. 2008;97(9):1205-1209.