Many parents hear that if you breastfeed lying down, their child will get otitis media. Does lying down and breastfeeding really give a baby otitis media? Some people around me say that their children do not get otitis media at all, even if they breastfeed lying down. Which statement is correct?

Why is it bad to breastfeed while lying down?

'Otitis media' refers to inflammatory changes in the middle ear cavity between the eardrum and the inner ear (cochlea). According to how long the elapsed period is after onset, it can be divided into acute otitis media (within 3 weeks), subacute otitis media (between 3 weeks and 3 months), and chronic otitis media (lasting more than 3 months). 

Your child may recover spontaneously from acute otitis media, but it may progress to otitis media with effusion or chronic otitis media. If you feed your baby while lying down, milk may enter their inner ear with each swallow. If you are bottle feeding, it is best to feed your baby at an angle of 45 degrees or more. When a child is in a lying down position, it makes their ear canal flat, which makes it easier for formula and foreign substances to flow into the middle ear.

In particular, be careful when sleeping.

If otitis media occurs frequently in your child due to lying down while breastfeeding, it is necessary to pay attention to their nighttime feeding habits as well as their daytime habits. Children who sleep while breastfeeding are more likely to develop otitis media. When a baby falls asleep while breastfeeding, the baby's mouth is full of milk, and this accumulated milk goes to the ears, which is a common cause of otitis media.

Also, if you lie down every time you breastfeed, it can be a problem because milk does not easily come out of your breast. If you sit and feed, your breasts will be emptied because the milk is drained in the direction of gravity. However, if you lie down while breastfeeding, breast milk is discharged in a direction perpendicular to the direction of gravity.

If you lie down every time you breastfeed, milk can remain in the breast and cause mastitis. Usually, it is desirable to sit in an upright position to breastfeed, and to lie down when breastfeeding only once or twice a day.

So, what should I do?

But that doesn't mean it's you have to get your baby out of bed every time to breastfeed. Mums are also human. What's the most practical way? First of all, if you have an adverse reaction such as a lump in your chest, do not breastfeed while lying down. It is also not recommended to lie down after every feeding.

However, if your breasts feel fine and your child doesn’t have a sleep connection of sucking and then falling asleep, it is okay to lie down 1 or 2 times a day. As mentioned before, when you lie down at night, be careful not to let your baby fall asleep while sucking. When this becomes a habit, it becomes difficult for the child to fall asleep, and bedtime for the mother becomes more and more difficult.

How should I lie down?

The side-feeding method is comfortable as it allows the mother to rest and minimizes the pain of the perineum incision. Lay face-to-face with the child and mother, so that the baby's mouth is over the mother’s areola. Roll up a pillow or blanket to secure it behind your baby's back.

You can put your arm on the pillow and feed your baby. Placing a rolled-up cloth or pillow between your knees also helps. Make sure your baby's nose is level with the nipples and don't let your baby bend their head to reach the breast.

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Author: Kwon Hyang-hwa
- Newborn Childcare Coach
- IBCLC International Breastfeeding Specialist
- Worked as the director of a postpartum care center for 10 years.