Clampdown Bite Reflex
Identifying and Managing Clenching Response in the Breastfed Baby
Clampdown bite reflex in the breastfed baby is a severe neurological response that deters breastfeeding. Identifying and properly treating CBR is critical to success.
Clampdown bite reflex can be an extremely painful deterrent to the breastfeeding relationship. Often misdiagnosed, clampdown bite reflex can result in intense breast pain that inhibits milk ejection and effects weight gain of the baby. The good news is that this clenching response can be managed by providing the mother with strategies to work with her breastfed baby.
Identifying Clampdown Bite Reflex
Clampdown bite is a reflex that occurs when anything is placed in the baby’s mouth and is generally present from birth. When the baby tries to swallow, the result is that he clamps down on the nipple with great force. It is much different than the more common issue of a quick bite. For the breastfeeding mother, this action cuts off blood supply to the nipple. After a feeding, the nipple may appear white, or have a white stripe going across on the nipple. In severe cases, the nipple may even appear to be bruised.
There are several factors that can further indicate the possibility of clampdown bite reflex. Babies born with neurological problems or babies born during a medicated labor/birth are more likely to suffer this condition. The mother may notice that the baby is difficult to cuddle, have increased muscle tone, or appear to have tense muscles. It is important to closely observe the baby during a feeding and watch how the baby responds to being held.
Other symptoms may include inhibited weight gain, inadequate sucking and swallowing, and an issue with milk ejection due to nipple pain.
Treatment Suggestions for the Clenching Response
- The biggest encouragement to provide the nursing mother is that clampdown bite generally goes away in a few weeks. As the baby’s neurological system develops, clamp down bite often diminishes.
- To help relax the facial muscles, the mother can wipe down the face with warm and then cool water, alternating each through out the feeding.
- Using her fingertip, the mother can exert gentle pressure on the baby’s chin to prevent or diminish the effect of the reflex.
- Calming the baby with massage may help relax the baby with excessive muscle tone. A great resource on infant massage is Infant Massage: A Handbook for Loving Parents by Vimala Schneider Mcclure.
- Figuring out what nursing position most relaxes the child is important. Many mothers have found that using the football hold, while swaddling the baby in a somewhat flexed position is the most beneficial.
- For particularly severe cases of clampdown bite reflexc that affect the baby’s weight gain, the mother may need to express her milk and using an alternative feeding device, such as a medical syringe or cup feeder. Alternative feeding methods will help avoid nipple confusion and permit the baby to have an easier transition back to the breast. Artificial nipples can actually exacerbate clampdown bite reflex.
- For clampdown bite reflex that does not improve with time, a mother may opt to exclusively pump her breastmilk. Mothers who wish to exclusively pump should be provided with adequate information and educated support to help her in this endeavor. Exclusively pumping mothers need to be encouraged to pump frequently and through the night in order to maintain an adequate supply.
Sadly, many mothers who wish to nurse their babies are often encouraged to quit nursing by friends and family. However, mothers who are supported during these challenging weeks may very well find that their babies with clampdown bite reflex can become efficient nursers. Further, if there is a neurological problem, these babies will benefit greatly from receiving breastmilk. It is very important for these mothers to receive the support and education that they so desperately need. By doing so, mothers and babies may be able to breastfeed for as long as is mutually desirable.
For further reading: Lanolin Treatment for Nipple Pain: The Proper Use of Nipple Ointment for Breastfeeding Mothers
Reference:
Clampdown Bite Reflex, by Mary Jozwiak, from LEAVEN, Vol. 30 No. 4, July-August 1994, pp. 53-4.
