Many parents worry about what to do if baby aspirated breast milk. Do not be worried at all because, I have searched for you to conclude all the aspects regarding aspirated breast milk.
Breastfeeding is considered as one of the sweetest moments of interaction between the mother and the child but at times it may prove to be worrying especially when a child chokes on the breast milk.
So, it is the best to consult your pediatrician for guidance on what to do if baby aspirated breast milk.
Aspiration means the act of getting feeds into the lungs instead of the gastrointestinal tract due to inhalation, for example, when a breastfeeding mum accidentally pours breast milk into her baby’s lungs.
This maybe a little worrying to any parent, but it is good to understand what is expected, what may cause it, and what should be done to avoid severe consequences on the baby.
Finally, this blog post is going to explain the details of what to do if a solid feeding baby aspirates breast milk and further preventive measures and treatments and prognosis.
What is meant by Breast Milk Aspiration?
Breast milk aspiration is a phenomenon wherein milk gets into the baby’s lungs instead of going to the stomach through the esophagus during feeding.
This may occur for instance if the baby experiences swallowing and breathing coordination while nursing or if there is a problem with feeding such as fast let down.
Ingested breast milk may cause mild irritation and if, in severe cases of aspiration, the child may develop pneumonia among other respiratory diseases.
The specific problem is urgent to be addressed in order not to escalate the problem. (Also Read, When Can a Baby Drink Juice for the First Time?)
6 Tips to Do if Baby Aspirated Breast Milk
If you are convinced that your baby has aspirated the breast milk, it is critical to respond to it in order to prevent further chest infections. Below are some actions you can take:
1. Stay Calm
This is the first suggestion, Do not panic. Mothers and other caretakers of babies should realize that the stress levels are easily transmitted, and remaining as calm as possible helps one to react better.
Stress can make the baby cry even more, and therefore taking a cool-headed approach will help one make the right decision.
2. Gently Position the Baby Upright
Support the baby upright because most of the time, milk will come out of the baby’s mouth and the airway.
Milk that has accumulated may be helped by gravity to clear, which may help the baby to breathe properly again.
It is also quite acceptable to further tap on the baby’s back in order to help him/her burp on his or her own.
3. Monitor the Baby’s Breathing
It will be important for you to carefully monitor the baby in case he/she has breathing problems.
If the baby seems to be gargling, chocking, or struggling for air, the help of a doctor should be sought immediately. Self aspiration can cause occlusion of airways, hence necessitating treatment.
4. Encourage Coughing
A coughing is an involuntary response of the human body which assists it in ejecting substances from the airway.
There is no need to eliminate the cough if the baby starts to have it. Support it by placing the baby upright.
Coughing facilitates removal of the milk from the lungs so that there is a diminished probability of the formation of further complications.
5: Avoid further Feeding Until Baby is Stable
As much as it is okay to feed the baby after an incident such as a fall, do not attempt to feed the baby again right after the event.
Give the baby sometime to rest and for him or her to breathe well before wanting more milk. If the feeding is done too early there are chances of aspiration which is an area of concern.
6. Seek Medical Advice
However, if the baby appears well after the aspiration of the breast milk, it is vital that the parent seeks medical attention as there may be complications such as aspiration pneumonia.
They might advise for continued monitoring or other approach to avoid future complications.
Causes of Breast Milk Aspiration
There are many reasons for aspiration of breast milk. One is that the baby may be unable to coordinate the suck-swallow-breathe pattern that is required during feeding.
It can be accompanied by a well-coordinated let-down reflex where milk lets down in a rate that the baby cannot handle.
Other factors include gastroesophageal reflux (GERD), or the presence of an anatomical abnormality, such as a cleft palate, or laryngeal cleft, which may also cause the baby to suck in breast milk into his airway.
Patients who have pre-mature infants or neurological disorders are also at a higher risk of aspiration because swallowing function may not be pronounced in such patients.
Impacts of Aspirated Breast Milk on Baby’s
Aspiration of breast milk may have diverse consequences based on the amount of milk that has been inhaled and general health status of the baby.
In mild cases, the baby may cough or gag and recover from this easily and without complications.
However, in the severe conditions the milk may produce irritation in the lungs which results in its inflammation or infection and in some instances it leads to aspiration pneumonia.
Continuous aspiration can lead to chronic lung diseases including bronchitis or decreased pulmonary clearance, which affects the future respiratory status.
An aspiration occurs when a baby inhales a foreign substance into his or her airway. So, one should observe the baby closely for any signs of change in breathing, behavior, or feeding.
Symptoms of Aspirated Breast Milk
The reflexes of aspirated breast milk may be accompanied by coughing or choking during or after feeding, wheezing or difficulty in breathing.
The baby may also show some distress, for instance, wriggling and arching, refusing to be fed from the breast etc.
At a time, this may cause the baby to develop some bluish tint in the lips or face because of lack of oxygen.
Symptoms arising from chronic aspiration in the baby include poor weight gain, frequent episodes of respiratory infections or a cough that lasts for a long period.
What a Mother Should Do to Avoid Breast Milk Aspiration
To avoid breast milk aspiration, proper feeding methods and the position of the baby should be considered.
To minimize the possibility of this risk, mothers should breastfeed the baby in an upright or semi upright position to enable the baby to control the flow of milk.
Frequent burping during feeding also helps in reducing the amount of air that gets into the stomach, hence minimize on the chances of reflux and aspiration.
Also, mothers who have forceful let-down reflex, they should help to expressed little of the milk before they allow the baby to latch on to avoid embarrassment of flow.
In babies with specific risk factors including premature baby or baby with reflux, feeding in small quantities and at set times will assist reduce aspiration.
How to Diagnose that A Baby has Aspirated Breast milk
Breast milk aspiration can be suspected and if this is so, the healthcare provider will examine the baby, especially the lungs and breathing.
A chest X-ray, may be requested in a bid to check for aspiration pneumonia or any other lung complications.
At times, passage of a thin tube with barium through the babies mouth may be done to assess how the baby feeds to rule out any factors which could have led to aspiration.
Management
Mainly, the prevention of further aspiration of breast milk and stabilization of any respiratory distress is crucial in the management of a child with breast milk aspiration.
If a baby is having breathing problems, suctioning or oxygen therapy may be required as the next step of treatment.
Besides suction and oxygen therapy there are many other techniques that can be employed for a baby who has aspirated breast milk.
Positioning is one of the simplest though very effective techniques such as placing the baby in an upright position will help to prevent further aspiration and encourages the natural expulsion of the liquid from the respiratory tract.
In extreme cases, chest physiotherap may be included to assist in the clearance of mucus in the lung so that the baby can easily expel secretions.
If the former condition is persistent in babies proving through respiratory distress, the use of continuous positive airway pressure (CPAP) is made to help widen the airways and assist in easier breathing.
At times, hydration therapy is essential as well as it aids in liquefying the mucus thicken and keep the airways of the baby patent.
Thus, by frequently performing pulse oximetry, the amount of oxygen that the baby is receiving can be determined and appropriate changes can be made as soon as possible if the amount being delivered is inadequate.
These management tools create synergy in enhancing the breathing of the baby thus eliminating pneumonia and other complications.
If aspiration happens over and over again, a feeding specialist or a lactation consultant should be consulted in order to change the woman’s nursing method or timing to minimize this chance.
Treatment
The management depends on the nature of the aspiration, which was in the severe form in this case.
The less severe forms of the disease do not even necessitate any interventions, but the condition of the child should be watched because of possible development of respiratory problems.
Specific management for a baby that has aspirated breast milk includes a lot of monitoring and the prevention of aspiration pneumonia.
If the baby seems perfectly healthy and does not appear to be suffering from an infection, it is possible to observe it at home.
However, if the baby displays some signs of ICH such as coughing, difficulty in breathing or having a fever, it will need to be treated.
Sometimes, doctors may recommend an antibiotic for instance, Amoxicillin or Azithromycin. Since the aspiration of breast milk may lead to pneumonia that is caused by bacteria.
These antibiotics have the capacity to slow the bacterial growth and assist the immune system in combating the disease causing bacteria.
In babies with severe respiratory problems, Bronchodilators like, albuterol are given to help to dilate the airways and therefore helping with breathing.
In extreme circumstances one may require admission to receive oxygen or frequent suctioning aimed at clearing the lungs’ passages.
Home management of breast milk aspiration is limited to close supervision, therefore aspiration should not be managed ‘at home’ as a rule of thumb.
Parents should of course consult a doctor when their child has signs of an infection or breathing troubles because these can cause problems.
In case of development of aspiration pneumonia, the patient will be given antibiotics to clear the infection.
In severe cases, the baby may be admitted for observation and or breathing support or referral for other probable causes.
Prevention
The only way to avoid aspiration of breast milk is through proper feeding technique.
Mothers should also watch the child’s signal and try different positions in order to help the child to swallow the food well.
Even if the baby refuses to feed, it’s advisable to feed him or her in small portions frequently then allow him/her to rest in-between meals to avoid chocking on milk.
It is also important not to offer a slow flow nipple on the bottles and the head of the baby should also be kept raised during feeding to prevent aspiration.
Prognosis
In the case of babies who aspirate breast milk depends of the recurrent incidents and the severity of the case.
From time to time, minor aspiration is normal, and provided that the situation is well managed, the prognosis is generally very favorable.
However, if aspiration is repeat, or if there is a condition such as pneumonia, then a doctor is going to need to further investigate the root causes.
If treatment is sought and if parents follow precautions advised by the doctors, majority of the babies are able to bounce back and progress further.
