It's relatively common for breastfeeding Mums to feel that one breast is perhaps not producing enough - or that baby feeds less well on one side: fussing and seeming to be frustrated when latching onto one side more than the other, coming off and when offered the other side, latching more easily and feeding well.

Most mums report that their babies have a favourite side, and often that the other breast seems to produce less, and baby is far more fussy on it, frequently only having very short feeds from the least preferred breast, and long settled feeds onlyfrom the favourite: it can just be a phase that your child goes through, but some get so much of a preferred side that they only feed from one, and actually, one-sided feeding is fine; after all, twins often feed from one breast only as their Mum will often allocate each of her breasts to a specific infant!

In fact, it is also very common for breasts to behave differently - however if you would prefer them to be more alike then there are certain things that might be worth checking through.

Obviously it's best first of all to eliminate any infection in the breast or in baby (sometimes it's lying on one side rather than another, not feeding at a particular breast, if baby has an ear ache or headache (see Cranial Osteopathy, below) - which can be seen quickly by lying baby on the same side (the 'good' side) to feed, by approaching the 'not so good' breast from a different direction, eg under the arm - the so-called 'rugby ball' hold - if normally fed in the cradle hold, etc) so check through whether it could be mastitus where relevant.

A common reason for a baby to have a headache which makes them feed more vaorciously from one side and more fussily from the other, is that the plates in the head can sometimes be mal-aligned, often following a rushed or traumatic birth, and this causes tension. Beacuse of this, Cranial Osteopathy may help with a baby that is not keen on latching on one side. They 'test' a baby's natural range of movement by encouraging them to turn their head to look at something interesting, first one side, then the other. A general reluctance to turn the head more than partially can indicate some physical tension there that may be released through gentle osteopathic treatment.

The fussy behaviour is unlikely to be a shortage of milk in the mother (perhaps from stress or triedness if a new phenomena), an allergy to something in the milk, or any other physiological issue, because that would affect both breasts equally of course.

It would also be wise to check for lumps, to rule our some sort of blockage: it could be nothing more sinister than a blocked duct or a fatty lump, or perhaps old scar tissue, but obviously if you find a lump that is not a blocked duct (which should be able to be dispersed by gentle massage, perhaps under warm water or with a wide toothed comb, or even better by getting baby to feed with chin to that segment of the breast) or anything else which worries you, then you should go and see your GP to check for any problems. It's unlikely to be anything too scary, but its always worth getting checked out.

In the event that you DO have a lump, then it's always possible that a local experienced midwife would be able to check for an abscess, [or maybe an Infant Feeding or Breastfeeding Co-ordinator] , and that they might be able to signpost you to the best person to clear it (by aspiration usually). Some hospitals will do an ultrasound of the breast which enables them to see if there is an abscess.

You may have tried expressing from the side your baby doesn't willingly take, and been disappointed with the result - but please rest assured that the amount you can express is not an accurate indicator of the amount your baby can suckle from you, as they are far more efficient at draining a breast than a pump could ever be! If you feel baby is really feeding only from the other side and you wish to breastfeed from both then a cause a 'cure' need to be established, but in the meantime do continue expressing from the 'fussy' side as much as you are able, perhaps to give to baby via a syringe or cup (depending on age - or a beaker if older) and to keep trying to breastfeed baby on that side as well, especially when sleepy, as many Mums with this issue report that baby will feed better from the 'fussy' side eg during the night.

Often the descriptions which mothers give of the 'fussy' breast and baby's behaviour do suggest that improving the baby's positioning and attachment on that side could be helpful.

It could be to do with the way you bring the baby to you on that side, since once a mother finds one side more awkward it can lead to quite a different way of handling the feed on that side, even with a hand round the back of the head 'because the baby fusses' for that side only! Babies don't like to have their heads restrained while feeding, so it WILL make for a fussier feed.

It may be worth considering if/where you sit to feed - if you routinely sit at one end of a sofa it may simply be either that you are leaning on the sofa-arm so the baby is brought too far across (nose round towards armpit), or if it the other way then it could be that your baby's feet are pushing off and their nose is too far round towards the armpit that way! Having a baby who has grown since the Mum learned to attach them 'properly' is a common reaosn for mums of older babies to start to have pain on feeding - because they simply haven't adjusted their position in line with their new bigger child!

However, whatever the reason for it if it IS sub-optimal attachment, it is important to remain watchful of the 'fussy' breast, and how you feel generally, as it is also possible that the symptoms point to a blocked duct which if left unchecked could become mastitus which is best avoided, or an abscess - see above.

If you aRE trying to get baby back onto breast, then once all the possible risks above have been checked for (mastitus, blocked duct, abcess etc) then once baby is feeding fromt he breast again, it's useful to encourage better flow of milk using a technique called breast compression
during feeds if you can keep baby on, and/or expressing after baby has given up feeding on that side. This would help to improve her supply over a few days.

It would be good get some continued support with this, because as you've already read, the amount you may be able to express isn't it isn't a true relection of the milk available to your baby, and it can take a couple of days to be effective, during which time your baby may actually be getting more milk directly at the breast anyway: you might notice this by the baby's improved behaviour and response. Often, after a pattern of 'fussiness' on one side has developed, and a supply on one side has been affected, the you'll need to have a plentiful supply in her breast for the baby to be interested in feeding there again.