Baby Prefers One Breast? Understanding and Managing Breast Preference

Breast preference occurs when a baby consistently favors nursing from one breast while refusing, fussing at, or showing reluctance toward the other breast.

This can manifest as:

• Crying or arching away when positioned on the less-preferred side
• Nursing contentedly on one breast but seeming frustrated on the other
• Shorter nursing sessions on the refused breast
• Accepting the less-preferred breast only when very sleepy
• Physically turning the head away from one breast

Important distinction: This is different from normal anatomical variation where one breast produces slightly more milk than the other—which is completely normal and rarely causes preference issues.

Understanding the root cause helps you choose the most effective solution.

1. Supply Differences Between Breasts

If one breast has developed significantly lower supply than the other, your baby may prefer the breast with faster, more abundant flow.

Why this happens:

• Starting feeds predominantly on one side
• Baby favoring one side during cluster feeding phases
• Mastitis or blocked duct affecting one breast
• Previous breast surgery on one side

This is the most common cause of breast preference and directly relates to milk production patterns. Understanding what causes low milk supply can help you address the underlying supply imbalance.

2. Anatomical or Positional Challenges

Physical differences can make one breast easier or more comfortable for your baby to feed from:

• Flat or inverted nipple on one breast
• Torticollis (neck muscle tightness causing baby to prefer turning one direction)
• Tongue tie or lip tie affecting latch effectiveness on one side
• Your body shape making one feeding position more comfortable

3. Flow Preference

Some babies develop strong preferences for milk flow speed—either preferring the breast with stronger letdown or getting overwhelmed by fast flow and preferring the slower side.

4. Temporary Illness

Ear infections, stuffy nose, or teething pain can make one feeding position uncomfortable, triggering temporary breast preference that may persist even after the illness resolves.

5. Habitual Preference

Sometimes preference develops simply from routine—always starting feeds on the same breast or offering one breast more frequently because certain positions feel easier to you.

Here's what matters: the less-preferred breast will gradually reduce production if the pattern continues unchecked.

Your body operates on supply-and-demand principles. When one breast isn't being emptied regularly and effectively, your body interprets this as "less milk needed here" and adjusts production accordingly. This creates a frustrating cycle:

1. Baby prefers one breast → Other breast isn't emptied fully
2. Less-preferred breast produces less milk → Flow becomes slower
3. Baby prefers the fuller breast even more → Supply gap widens
4. Eventually, significant supply imbalance develops

The good news: This cycle can be interrupted and often reversed with consistent intervention.

Strategy 1: Start Feeds on the Less-Preferred Breast

Offer the refused or less-preferred breast first at every feeding when your baby is hungriest.

Why this works: Babies nurse most vigorously at the beginning of feeds. This ensures the less-preferred breast gets emptied effectively, signaling your body to maintain production.

How to implement:

• Offer the less-preferred breast when baby first shows hunger cues
• Let baby nurse until they pull off naturally (don't switch too early)
• Then offer the preferred breast to finish the feed
• At the next feed, start with the less-preferred side again

If baby refuses completely: Try offering when baby is drowsy (just waking or falling asleep), during skin-to-skin contact, or while walking/rocking.

Strategy 2: Pumping to Maintain Supply

If your baby consistently refuses one breast, pumping becomes essential to maintain supply and prevent mastitis.

Pumping protocol:

• Pump the refused breast whenever baby nurses from the preferred side
• Aim for 15-20 minutes per pumping session
• Focus on regular, complete breast emptying rather than volume
• Store expressed milk for later feeds or supplement bottles if needed

Understanding how to choose the best breast pump and proper pumping techniques will help you maintain supply effectively on the refused breast.

Consider using reusable breastmilk storage bags to safely store the milk you express from the less-preferred breast.

Strategy 3: Position Switching

Sometimes the position, not the breast itself, is the issue.

Try different feeding positions:

• Football hold: Tucks baby under your arm, good for babies with neck preference
• Cross-cradle hold: Gives you more head control
• Side-lying: Can work well for babies with ear infections or torticollis
• Biological nurturing (laid-back): Lets baby use gravity to help with latch

Position trick: Try feeding from the less-preferred breast while positioning your baby the same way as the preferred breast (you'll be in a different position, but baby's body orientation stays the same). For example, if baby prefers your left breast in cradle hold, try football hold on the right breast so baby's body is still angled to the left.

Strategy 4: Address Underlying Physical Issues

If you suspect anatomical causes:

For suspected tongue tie or torticollis:

• Consult a pediatric dentist, ENT, or lactation consultant (IBCLC)
• Craniosacral therapy or pediatric physiotherapy may help with torticollis
• Tongue tie revision may be recommended if affecting latch

For flat or inverted nipples:

• Use nipple everters or gentle stimulation before feeds
• Try different positions that allow deeper latch
• Hand express a little milk to encourage letdown before latching

Strategy 5: Compression and Breast Massage

If flow difference is the issue, use these techniques on the less-preferred breast:

During feeds:

• Apply gentle breast compression while baby is actively nursing (compress when baby pauses between sucks)
• This increases milk flow, making the breast more rewarding

Before feeds:

• Massage the less-preferred breast to encourage letdown
• Hand express a small amount to trigger faster initial flow
• Warm compress can help stimulate letdown

Strategy 6: Support Galactagogue-Rich Nutrition

While breast preference is primarily a mechanical/behavioral issue, supporting your overall milk production helps maintain supply in both breasts during this challenging phase.

Include galactagogue-rich foods in your daily nutrition, particularly if you're concerned about supply on the less-preferred breast. Lactation cookies can provide convenient support, especially allergy-friendly options if you're managing food sensitivities.

Quality lactation cookies can provide convenient galactagogue support during this period, though they work best as part of a comprehensive approach that includes regular breast emptying.

Consult a lactation consultant (IBCLC) or your GP if:

• Breast preference persists despite consistent attempts over 1-2 weeks
• You suspect physical issues (tongue tie, torticollis, ear infection)
• Supply in the refused breast is dropping rapidly
• You develop blocked ducts, mastitis, or severe pain
• Baby is not gaining weight appropriately
• You're feeling overwhelmed or defeated by the situation

In Australia: Your local maternal child health nurse can provide initial support and may refer you to IBCLCs. The Australian Breastfeeding Association (ABA) also offers telephone and online counseling.

If you're dealing with breast preference right now:

1. Identify the likely cause by reviewing the causes listed above
2. Start with drowsy offers when baby is just waking or falling asleep
3. Implement the first-offer strategy consistently for at least one week
4. Pump after refused feeds to maintain supply
5. Try position variations to find what works for your baby
6. Seek help if needed within 1-2 weeks if you don't see improvement

For comprehensive support:

Return to our complete Breastfeeding Nutrition & Milk Supply guide for broader strategies supporting your breastfeeding journey, including nutrition approaches that support overall milk production in both breasts.

Breast preference is frustrating, but it's manageable with patience, consistency, and the right support. You're not failing—you're problem-solving a common breastfeeding challenge with care and determination.