Ask Dr. Sears: Stopping Baby Bites

Q  Breastfeeding my baby has become painful since his top front teeth have come in. As a result of his biting, my nipples have become red and painful. What can I do?
A It's a fact of life that some babies do bite the breast that feeds them. Biting during breastfeeding is particularly jarring because you're startled during a very relaxed state induced by the calming hormones produced by the body while breastfeeding. Babies naturally want to use their favorite pacifier as a teething ring. Your son not only has learned to associate the breast as a source of nutrition but also as a source of comfort. His habit of biting you, however, can usually be broken if you're not ready to wean him.

First, however, you'll want to prevent a breast infection and allow your nipples to heal. Try air-drying each nipple after every feeding, and, because of the natural healing properties of breast milk, you'll want to massage a few drops of expressed milk onto your nipples several times a day. Also, frequently apply a pure lanolin ointment to you nipples.

As for a long-term solution, you'll need different tactics to alter your baby's behavior. When your son bites the nipple, your natural inclination is to yell "Ouch!" and yank him off the breast; this sudden reaction may shock baby enough so that he may get the message: Don't bite. Some supersensitive babies, though, may go on a temporary nursing strike and will need to be wooed back into breastfeeding. If the yell-and-yank response seems to have no effect, try these techniques that worked well for our little biters:

Keep a breastfeeding journal to track what triggers his biting. You may find that your baby tends to bite when he's very hungry. If this is the case, try to feed him more frequently (prompted by reading his hunger cues).

As soon as you feel him begin to bite, draw him in very close to your breast, covering his nose in the process, so that he'll have to stop biting to be able to open his mouth and breathe.

When you feel baby start to clamp down, insert a finger in the corner of his mouth, keeping the finger between the breast and his teeth. To further protect your nipple, don't yank your nipple; instead, work your finger between his gums and pry the jaw apart. Then, hook the end of your finger around your nipple to protect it as you withdraw it from his mouth.

Another technique is to use your index finger to depress baby's lower jaw when it starts to close. This is particularly useful for babies who have tight mouths and chomp on the breast: It teaches them to suck without clamping down so hard.

Baby can learn that the consequence of biting is a premature end to nursing. When he begins to bite, repeatedly end the feeding, putting him down firmly, but not in a punitive way, until he gets the idea. He should eventually realize that if he bites, he will be put down.

Biting often occurs toward the end of a feeding, when baby's sated but wants a few more minutes of "comfort sucking." When he's nearing the end of the feeding, you can intervene by giving him something to chew on. Frozen teething rings, your fingers, frozen bananas, and cold washcloths are all popular teethers.

Finally, if your nipples are still sore even after your son has stopped biting, use a nipple shield for a few days. Using these techniques should help your son to realize that he needs to learn some nursing manners in order to get a fully satisfying meal, and that breastfeeding needs to be a pleasurable experience for both baby and mother.