September 22, 2020

By Andrea Tran RN, BSN, MA, IBCLC

It can be frustrating if your baby shows a preference for one breast over the other. It is standard breastfeeding advice to offer both breasts and alternate which side you start a feeding with. However, some babies are not on board with that plan. I’ll explain why it might be happening and what you can do about it.

Is it common for a baby to prefer one side?

This is not an area that has been extensively studied. Researchers in Saudi Arabia did look at the occurrence and found that of 480 moms approximately 26% reported their babies exhibited breast preference.

Why do babies show breast preference?

There are a variety of reasons breast preference may occur.

• Greater milk supply on one side. This is common. One study reported mothers who were exclusively pumping documented an equal volume pumped from both breasts less than 3% of the time.
• Differences in nipple size or shape
• Breast preference in the early days of nursing may be due to bruising of an infant’s head. If this is the case the preference will probably be short-lived.
• Infants with torticollis, or a “stiff neck”, may be more comfortable laying on one side over the other.
• A child with an ear infection may fuss or cry if positioned with that ear down.
• A mother may be more comfortable holding her child on one side over the other due to hand dominance.

Is it a problem for me if my baby prefers one side?

If one breast is producing most of your baby’s milk you may have one breast that is noticeably larger than the other. Sometimes this leads to issues with clogged ducts. If you don’t experience that, your baby’s breast preference is not a problem from a health perspective. However, if a lopsided appearance bothers you, you can try to help your baby take both sides equally.

Related: How to get rid of plugged milk ducts and prevent them from happening

Is there anything I can do to help my baby take both breasts equally?

Having success in getting your baby to take both breasts will depend on the reason for the breast preference.

The amount of stimulation a breast gets can affect how much milk is produced on each side. You could try doing some pumping on the non-preferred side after breastfeeding. Breast compressions while nursing can help increase the flow and aid in thoroughly draining the breast.

If breast preference is occurring due to an infant’s discomfort from a bruised head, torticollis or ear infection using the football hold may make it more comfortable for a child to take the non-preferred breast.

If the reason for the breast preference is unknown a mother could try offering the non-preferred side first at every feeding for a few days to see if that helps her baby get over what is causing the breast preference. Infants may be less picky when they are hungrier. Mom may want to pump the other side if it is not getting drained adequately.

Another recommended technique is to latch the baby on the side they like better and then after a few minutes try gently detaching them and sliding them over to the other breast.

A lactation consultant can help you determine the reason for the breast preference and guide you through these techniques.

What should I do if my baby refuses to take the other side?

Initially, I would recommend pumping that side. If all the above techniques do not change your baby’s mind and your baby is gaining weight at an adequate rate you can accept your baby’s preference and wean off the pumping. What is most important is that your baby gets the amount of food that he needs to grow properly. If that can happen by feeding on one breast the breast preference does not need to be an issue.

Sources

Al-Abdi S.Y., Al Omran S.A., Ali Al-Aamri M.A., Al Nasser M.H., and Al Omran A.M. (2015). Prevalence and Characteristics of Infant's Unexplained Breast Preference for Nursing One Breast: A Self-Administered Survey. Breastfeeding Medicine, 10:10, 474-480. https://doi.org/10.1089/bfm.2015.0116

Hill, P. D., Aldag, J. C., Zinaman, M., & Chatterton, R. T. (2007). Comparison of Milk Output Between Breasts in Pump-Dependent Mothers. Journal of Human Lactation, 23(4), 333–337. https://doi.org/10.1177/0890334407307575

Andrea Tran RN, BSN, MA, IBCLC is a freelance writer who has been helping moms and babies breastfeed for over twenty-five years. She is married and the mother of three adult children.