Question: Sometimes when she’s nursing, my three month old will cough and cry and I notice that breast milk comes out of her nose. Is this just a reaction to my milk letting down too quickly, or could it be a physiological problem with the baby’s nose & throat? This is my fifth breastfed child and I have never encountered this problem before.
Answer: It’s not unusual for milk to come out of a baby’s nose when they are swallowing too quickly or the flow of the milk is unusually forceful. This is generally only a serious problem when a baby has trouble coordinating sucking and swallowing, and often occurs when babies are premature or have neurological problems such as Down Syndrome.
If your baby was a newborn, I would be more concerned about this and wonder if there was a medical problem. In an older baby, chances are it’s just that she is reacting to the flow of the milk and just swallowing too much at one time. Sometimes babies this age get distracted when they are nursing (especially if older siblings are around and there’s a lot going on while they are trying to feed) and they end up not paying attention to what they’re doing – for example, she may be trying to turn her head and see what’s going on in the room while she is swallowing, and may just “forget” to swallow when she should. This could cause her to choke a little and make the milk back up in her nose.
I was holding my six week old grand daughter last week, and the same thing happened. Her mom has a very abundant milk supply, and when baby Juliet pulled off the breast, milk sprayed everywhere! She was spitting up a lot as well, but she is a perfectly healthy baby who is gaining weight just as she should.
I’s suggest calling her doctor and describing the problem, and he or she can tell you if they think you need to bring her in to be checked. They are probably going to tell you that if she is generally healthy and gaining weight well, then not to worry about it. However, if it occurs often enough to be a concern for you, it’s always better to be safe than sorry and have it checked out.
Anne Smith, IBCLC