Help, I’m being bitten!

Most mothers experience being bitten at least once or twice by their baby at some point during their time breastfeeding. However, not all babies bite and for a lucky few mothers this might be one experience that they never have to worry about. Unfortunately, some infants seem to do it more than others. Of my own three children, the first two only bit me once or twice. It was a shock at the time but nothing much came of it and was certainly not an ongoing issue. My third, however, was a regular biter starting before he was even 24 hours old!

Even before they get teeth it can really (and I mean really) hurt. There can be some real strength in those bits and their little teeth can be surprisingly sharp. I know there have been times myself where I have felt the need to check to see if I still had a nipple attached following one of the more decent bites. It’s normal and completely understandable to feel trepidation about bringing an infant back to the breast after they have bitten you. As nerve wracking as it can be, biting can be managed and even prevented so it doesn’t have to mean the end of breastfeeding.

There are a few reasons why a baby might bite while on the breast. Understanding the most likely cause will provide you with a starting place to figure out an appropriate solution. Beginning with the first and biggest clue about why it might be happening, consider when the biting appears to predominantly occur. Is it happening mostly at the beginning, middle or end of a feed? Most mothers can describe a particular point during the feed when the biting seems most common. However, for a few it might happen at more than one point during a feed or feel completely random with no discernible patterns. This just means there's likely more than one reason for your baby’s biting and so you might need to employ a few different strategies. Read on to look at why biting is likely happening based on the point at which it is occurring during the feed and some strategies for what you can do about it.

At the end of a breastfeed

I thought I would start here as this is the most common time a baby will bite and is pretty much always because they have finished filling up their bellies and are now playing with the nipple. Unfortunately for us they don’t realise that this game is actually quite painful for us, some even appear shocked or begin crying when we jump or shout from the sudden surge of pain. In the past, mothers were instructed to make a loud scream, put the baby down or perhaps even bite their baby in return as a way to teach them not to do it again. We now know that this really doesn’t work well and certainly not at all for very young babies. Babies brains are still very much under construction and their ability to learn behaviours or resist impulses (in this case to not bite mummy) doesn’t come for some years. A newborn really isn’t going to learn much from these responses and sadly there have been cases where infants have become frightened and developed an aversion to the breast because it became associated with a negative experience.

To prevent this kind of biting, pay close attention to when your baby looks like they are nearing the end of their feed and take them off before they get a chance to bite you. You can look for things like reduced sucking and swallowing or long pauses. Its normal for babies to have pauses during a feed and with close watching and practice you’ll soon become the expert on your own babies signs of when they are nearing the end of a feed. Be sure you are not ending the feeds prematurely (click here to read about the signs of enough milk intake). It’s okay if you mistakenly take them off, thinking they were finished, only to find your baby protesting and requesting to continue breastfeeding. You can always offer the breast again. Even the most experienced breastfeeding mothers get it wrong at times.

To be able to notice when your baby is nearing the end of a feed, most mothers find they need to minimise their own distractions from things such as phone use, TV or even chatting with others while breastfeeding. You might find you need to do this for all or only certain feeds throughout the day or night but it’s likely it won’t be something you will always have to do.

During a breastfeed

Are you finding your baby biting randomly during the middle of a feed. This is often because the baby is wanting more milk or perhaps milk more quickly than what they are currently getting. We have multiple letdowns throughout a breastfeed. You might notice that your baby’s suck pattern returns to that faster sucking like you saw when they were initiating the first letdown or perhaps you might have noticed that they aren’t swallowing as frequently. They may also appear to become fussy at breast pulling on and off before they get a chance to bite.

You can manage this by either taking them off the breast for a break, changing feeding positions or switching sides. If you begin to notice the same signs after offering the other side, some mothers will switch back to the first breast or provide some hands on compression to increase the milk flow. You can continue switching breasts if this is working for you both. Frequent switching can lead to an increase in milk supply. For some mothers this is warmly welcomed while others find it unnecessary and problematic.

You can also look for potential causes of discomfort. Perhaps they had become hot or uncomfortable in the one position and so the change provides just the relief they need to get on with breastfeeding. They might need a nappy change or benefit from a chance to burp.

Just like in the previous section, this likely means you will need to limit your own distractions so that you can pay close attention to your baby while they are feeding in order to act before any biting can occur.

Beginning or early into the breastfeed

Are you noticing your baby’s biting is happening mostly at the very start or early into the feed? This could happen for a variety of reasons. Often it comes down to a mix of personality, (IE a baby who wants the breast milk and wants it now) coupled with incorrect tongue position and lack of immediate letdown. Only a small amount of breast milk is available to your baby until your letdown has been initiated. Most mothers find there is a slight delay between when they bring their baby to the breast and when their letdown occurs. It can be difficult for your baby to latch and suck efficiently enough to stimulate a quick let down when they have become fussy or distressed. This might be because some of the early hunger cues have been missed or you weren’t in a position to feed your baby straight away, or perhaps you just have a baby that can go from 0 to 100 in a matter of seconds. Either way, a crying baby will usually have their tongue raised up and not in the correct position to achieve an effective latch, increasing your chances of being bitten.

You can try using calming techniques before bringing your baby to the breast such as rocking, walking or letting them suck on a clean finger just to name a few suggestions. Do what works for your individual baby. Some mothers might manually stimulate a letdown so that the milk is available as soon as the baby latches.

Stress and anxiety can further delay the letdown. It’s understandable to feel apprehensive about feeding a baby that has bitten you or feeding on damaged nipples. Do what you need to do to calm yourself as best as possible. This might be taking deep breaths or giving yourself a pep talk for example. Some mothers might even choose to use a nipple shield temporarily. This has it’s pros and cons so weigh up whether this is the right choice for you.

In contrast, some babies will latch fine but clamp down as soon as the letdown occurs. Babies do this more often when the flow of breast milk is fast and forceful. Clamping down on the nipple helps slow the flow in the same way as it would if we were to bite down on a straw or kink a garden hose. Some babies appear to do this instinctively rather than having any conscious awareness or doing it by choice. Some mothers find it helpful to manage this by either stimulating a letdown and catching the initial milk before offering the breast to the baby or allowing the baby to stimulate the letdown then taking them off the breast to catch some milk until the flow has eased before offering the breast back to the baby. How you catch that milk and what you do with it is up to you. Some mothers might collect it to use or donate while others will use a cloth or breast pad to catch it. Some mothers find they only need to do this in the early period while their supply is establishing or just until their baby has grown big enough to handle this fast and/or forceful let down. Some find this is needed for certain feeds such the first morning feed or when there has been an unusually long gap between feeds.

Another reason that can explain biting at the start of breastfeeding may be due to illness such as a blocked nose or other discomforts such as teething (I’ll talk more on teething later). It is difficult for a baby to breastfeed with a blocked nose and some can become frustrated. You can try feeding in a more upright position using as many pillows as needed to keep yourself comfortable. You can use other comfort measures to help clear your baby’s nose but often is just a matter of feeding as best you can and riding it out together. Stimulating a letdown before bringing your baby to the breast may help reduce their workload. Always seek medical advice if you have concerns about your baby’s health.

Sometimes the biting gives us clues about discomfort such as a sore neck, head or shoulders, perhaps sustained during the birthing process. You can try different feeding positions or offering your baby a massage. Some mums find seeing an osteo or physio with specific neonatal training helpful too.

Finally, some babies will cue for a feed when it's actually a different need to which they require attending. Often this is sleep but can also be boredom or lack of stimulation to name a few. They may show hunger cues and happily take the breast at first but as soon as you have a letdown it appears as though your baby becomes angry or even offended by the milk’s presence. They might pull off and on repeatedly, bite or show some other forms of protest. Most babies will breastfeed to sleep but a select few won’t. Or perhaps this is part of their witching hour (click here to read more about surviving the witching hour). You might have to use strategies other than breastfeeding to meet their non-nutritive needs, even when they appear to be requesting a breastfeed.

A word on Teething

Just as our babies start getting teeth, it's so common to receive comments about weaning to avoid being bitten. The truth is that if your baby is well positioned at the breast they really can’t bite you without hurting themselves in the process. When a baby is properly attached and feeding well their tongue will be forward, over their gum line (or bottom teeth if they have any), cupping the nipple and some of the surrounding areola. They would have to bite their own tongue in the process of biting you. So let’s be very clear that the presence of teeth or teething in general is not a sign that you need to wean for fear of being bitten. You’re unlikely to feel the teeth let alone be bitten just because of there's new chompers.

With that said, it is true that some teething babies with tender gums may have the urge to bite and chew to relieve their discomfort. Unfortunately, this can occur during breastfeeding. Sometimes offering your baby something hard and/or cold to chew on can help. Some mothers like to freeze breast milk and give their baby breast milk icy-poles. Other babies prefer rubber teethers more and may find they bite less if this has been offered before a feed. Some mothers may also find providing analgesia helpful to relieve their baby’s discomfort further reducing their urge to chomp on your nipple.

Occasionally some mothers report feeling the top teeth resting on the breast during a feed or notice little indentation marks on their areola when the baby comes off. This is more common when the baby prefers a shallow latch. Newly erupted teeth can be sharp and some mothers find it unpleasant at first. You might find it helpful to go back to basics and provide your baby the opportunity to adapt their attachment to accommodate the new teeth. Mothers may find the sharpness of the new teeth only lasting a short while and that a nipple shield is helpful for comfort while the teeth are coming through. Both feeling the teeth resting on the breast during a feed or the baby preferring a shallow latch are only a problem if they are a problem. If it’s not causing you any pain and your baby is feeding well then continue on as you are.

When its not biting at all

Very occasionally a mother will report feeling something sharp in their baby’s mouth only to discover food or something else in there being the cause. It can be worth checking inside your baby’s mouth, especially if they are at the stage of moving around and putting things in their mouth.

Biting first aid

Being bitten can bring out some primal feelings, including anger and rage. For this reason, sometimes it's better to put your baby down in a safe place while you calm yourself, and perhaps tend to any inflicted wounds.

If your baby has broken the skin you can use breast milk, expose your nipples to fresh air and ensure you are regularly changing any breast pads or bras to avoid potential infections. Again, a nipple shield may be helpful for a day or two while it heals. Continue breastfeeding. Unless you have been advised by your doctor otherwise, your baby will be fine if they consume a little bit of your blood. See your doctor if the wound is not healing or you develop signs of infection.

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Emma Biggar is an International Board Certified Lactation Consultant (IBCLC), Registered Nurse and mother of three. Emma provides in-home breastfeeding and early parenting support to families in the Eastern and South Eastern suburbs of Melbourne. Click here to read more about the types of services available or here to visit the online booking page. Contact Emma by email here or visit her website or Facebook page.