top of page
  • Writer's pictureChristi Boujikian


Many new moms experience pain and hardships when it comes to breastfeeding and instead of getting the help they need, they assume it's normal for them to not be able to be successful, give up, and immediately transition to bottle feeding. One way that I hope the “norm” continues to change is that all parents know how and can get functional feeding evaluations for their babies. Ideally, this should happen as soon as possible after birth or within the first few days postpartum.

functional feeding evaluation, breastfeeding

Most moms only receive basic breastfeeding instructions at the hospital right after birth. Unfortunately, many of the lactation consultants in US hospitals have not done continued education in oral function and are not equipped to complete an evaluation and provide ongoing individual support that is necessary for the feeding journey.

The professionals best suited for conducting functional feeding evaluations are IBCLCs (International Board-Certified Lactation Consultants) with continued education in oral function and SLPs (Speech Language Pathologists) or OTs (Occupational Therapists) with an infant feeding specialty.


The standard of care should be that all moms can receive a functional evaluation for their baby right away and not have to wait until there is trouble or uncertainty in the air. Obviously, weight gain is important, but it's not the only measurement of a baby's feeding skills as dysfunctional feeders are out there gaining weight as we speak.

To get an accurate assessment, a baby's latch, swallowing mechanics, the coordination of the suck-swallow-breathe pattern, and any possible compensatory or tension patterns should all be assessed by a trained feeding professional.

"A baby cannot compensate for something and not give something away. The compensations that a baby goes through to make up for abnormal breastfeeding comes at a cost. A baby who can’t get their tongue up to the palate to release endorphins will find something else to replace the need: a pacifier, a thumb, fingers, etc.” ~ Jennifer Tow, BFA, MA, IBCLC, RLC, OMT

When these basic mechanics are off, besides weight gain, it can affect a baby or infant's quality of life. According to Abeille Speech and Feeding, signs and symptoms of oral dysfunction in breast or bottle-fed babies and infants can look like:

  • Difficulty latching

  • Clicking noise during feeds

  • Frequent spit-up

  • Gassy

  • Fussy

  • Colicky or colic

  • Choking or coughing during feeding

  • Frequent unlatching

  • Milk leaking from mouth while feeding

  • Tucked upper or lower lip while feeding

  • Chewing or chomping on breast or bottle nipple

  • Feeds consistently lasting longer than 30 minutes

  • Feeding very frequently (consistently under 2 hours)

  • Baby seems frustrated during feeds

  • Poor sleep

  • Noisy breathing or snoring

  • Open mouth posture

  • Mouth breathing

  • Difficulty with solids

  • Difficulty with textures

  • Excessive gagging

  • Vomiting during meals

  • Food refusal

  • Fussy during meals

  • Lack of chewing

  • Difficulty with straws or open cups

  • Restless sleep

When it comes to poor feeding mechanics, it's not just the baby that can be impacted. An infant experiencing oral dysfunction when feeding can also affect the mom:

  • Pain with breastfeeding

  • Misshapen nipples after latch (can be lipstick-shaped or other)

  • Nipple damage

  • Recurrent clogged milk ducts

  • Recurrent mastitis

  • Breasts feel full after feed

  • Low milk supply

  • High stress and anxiety around breastfeeding

Ensuring that the proper mechanics for feeding are in place is the first step in the airway journey. When the muscles of the tongue and face can work in harmony to help grow the jaws wide and forward, airway development is off to the best possible start.

Many insurance companies cover these functional feeding evaluations with IBCLCs. Many of these specially trained IBCLCs offer prenatal appointments so they can help you prepare before your baby arrives. Additionally, having this postpartum feeding support in place will be beneficial for guidance on optimal products for baby – like ideal nipple shapes, mindful pacifier use, help with pumping if desired, optimal teethers and how to get the tongue moving, and so much more!


One of the biggest benefits of exclusive breastfeeding is the long-term health benefits it provides your baby. Breastfeeding has been found to help reduce the risk of many illnesses and diseases including:

  • Middle ear infections

  • Excessive colds and gut infections

  • Intestinal tissue damage

  • Respiratory tract infections

  • Allergic diseases

Additionally, breastfeeding helps your baby develop habits that will have an impact on their breathing and airway health. It also helps to properly develop their pallet and strengthen their tongue and mouth muscles.

"Breastfeeding to an infant is as important as a breath or a heartbeat. It is a vital sign. It is a physiologic function that must be assessed. If an infant cannot breastfeed, we must ask ‘why?’ and ask why until we have identified the issues that can be rehabilitated." ~ Michale Chatham, BSN, LMT, OMT

The airway benefits include teaching your child to breathe correctly through their nose and not their mouth, helping to prevent sleep issues such as snoring.


If there is anything that diving into this airway journey has taught me, it’s that going at it alone is not the way to do it. Set up a care team around you and your baby to access all the resources and support you need and deserve!

IBCLC directory for those trained in oral function:

Have a baby… and get a functional evaluation!!! No matter if it is your first baby or your seventh. Feeding is like an intricate dance, and now you have a whole new partner! Not to mention all the important details these highly trained professionals will be able to assess for you.

webinar, sleep disordered breathing

Recent Posts

See All


bottom of page