Are you struggling through feeding a baby with a recessed chin? I feel you, mama! My son, Jack, was born with a recessed jaw, and feeding my newborn presented so many hurdles, especially with breastfeeding.
Along with telling you my particular struggles with Jack’s newborn recessed chin (also called micrognathism or micrognathia), this article will walk you through the following:
- Tips for Getting a Diagnosis
- Tips for Feeding a Baby with a Recessed Chin, and
- What to Expect/Further Issues You Might Encounter
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What Does it Mean to Have a Baby with a Recessed Chin?
I remember looking at Jack in the hospital and asking my mom, “Are all babies’ chins so far back?
She replied that she’d never noticed before, but it was probably normal.
Major breastfeeding struggles, a lip tie and tongue tie clip, and a tremendous amount of pumping later, I finally called a lactation consultant. She gave me lots of advice and exercises, but ultimately, she diagnosed Jack with a recessed chin, which she called micrognathism (or micrognathia).
According to the Children’s Hospital of Philadelphia, “micrognathia is a condition in which the jaw is undersized. It is a symptom of a variety of craniofacial conditions. Sometimes called mandibular hypoplasia, micrognathia may interfere with your child’s feeding and breathing.”
It sounds really scary, and it can be connected to some scarier issues that Dr. Google will happily tell you all about. But for most children, it’s a minor condition that they grow out of.
A lactation consultant in my favorite online mom group said that most children she sees with this issue grow into their jaw between their 10th and 12th week. If not fully, at least well enough to latch.
My own lactation consultant provided me with abundant emotional support for this diagnosis, and a bit of an explanation. While there are various causes of a newborn having a recessed chin, she explained that the jaw tends to finish development at the very end of pregnancy. Since Jack had been induced at 37 weeks due to pre-eclampsia, his tiny jaw still had some growing to do.
Symptoms of Micrognathia
If you’re concerned that your newborn has a recessed jaw, or micrognathism, be on the look out for a few common problems.
I literally could see Jack’s–I wondered about it before we even left the hospital, after all.
According to Children’s Healthcare of Philadelphia, other symptoms include:
- Difficulty latching/feeding
- Prolonged feeding
- Noisy breathing
- Short spells of not breathing
- Noisy breathing
- Poor sleep
- Poor weight gain
Notice that many of these things go together. Difficulty feeding, for instance, will lead to poorer sleep and poor weight gain. Thanks, micrognathia.
Side note: I get really annoyed when I read things like “poor sleep” as a symptom of anything in a newborn. I know some sleep better than others, but seriously, no newborns sleep well. I’m not going to lie, I don’t know what this means. But it’s listed by what’s basically regarded as the best children’s hospital in the U.S., so I’m going to go with it.
How To Get a Diagnosis for a Newborn Recessed Chin
If you fear your newborn may have a recessed chin, there are a few steps you can take to confirm a micrognathia diagnosis.
The most obvious is to ask your pediatrician. They’ll evaluate things like your child’s facial structure, lip and tongue tie, and the positioning of the upper jaw relative to the lower jaw. With a newborn recessed chin, the lower jaw is generally further back than the upper jaw.
If your concerns about a recessed chin have to do with being able to breastfeed a child with a recessed chin, then I recommend speaking with an International Board Certified Lactation Consultant (IBCLC).
Often babies with a recessed chin have difficulty breathing and latching. The primary struggle with a baby with micrognathia latching is that they cannot move their lower jaw far enough forward to get a good seal over your nipple. For this reason, using a bottle or nipple shield can make your life much easier.
You’re also in the tough days of postpartum recovery, and you’re weary. It’s not a recipe for success.
Reaching out to a lactation consultant during this time was one of the best decisions I’ve made. I love, adore, and cannot say enough amazing things about Danielle from Oasis Lactation Services. Danielle is an International Board Certified Lactation Consultant (IBCLC) and Certified Lactation Counselor (CLC) accredited through the Academy of Lactation Policy and Practice based near Minneapolis, Minnesota.
I seriously cried when she left Atlanta. And I wasn’t even nursing anymore. But! She practices telehealth, so she can work with you no matter where you’re located.
According to Danielle, there’s no centralized place to find a good lactation consultant. She recommends Zip Milk if it’s in your area, and says you can confirm your lactation consultant’s certification through the International Board of Lactation Consultant Examiners (IBLCE).
Your lactation consultant won’t be able to perform the crazy tests that hospitals can, like a series of x-rays, or a sleep study (if necessary–remember, most micrognathism is rectified through the normal infant growth process). If the issue is so severe that you think those tests may be necessary, definitely talk to your pediatrician.
Tips for Feeding a Baby with a Recessed Chin
If you want to breastfeed a baby with a recessed chin who is having trouble latching, I cannot reiterate enough the importance of a lactation consultant. They’ll help you figure out where the problems may lie and if there are things you can do to overcome them.
I also strongly recommend the Mamivac Nipple Shields by Spectra, which I found to be way better than the more common Medela or Lanisoh ones. Nipple shields create a vacuum seal to your nipples, but stick out more directly, and are thus easier for baby to latch onto.
You should see milk in your nipple shield to know your baby is getting milk. You can also have your lactation consultant weigh your newborn before and after feeding to be sure they’re getting fed through the shield.
But honestly, if your newborn’s recessed chin is as severe as Jack’s was, it’s probably time for you to make a choice regarding feeding your baby. Here are your options:
- Breastfeed with a nipple shield and supplement with formula
- Breastfeed and pump
- Formula feed
My lactation consultant was very supportive of all of these options. I told myself before having Jack that I would be lax about the whole breastfeeding thing–we’d do it if it worked, and we’d formula feed if it didn’t.
But when he was born with micrognathism, that all went out the window. Breastfeeding became the center of my universe. I HAD to do it. There was no logical reason, and I’m a full proponent that fed is best. But for some reason, I insisted on giving Jack breast milk.
If this is you, mama to a newborn with a recessed chin, then settle into a comfy spot with a good breast pump and plan to stay closely attached. I walked around with mine so much that my friends and family just became accustomed to it.
I was lucky in that my hospital allowed me to rent a Medela Symphony, their hospital-grade breast pump, which is great for milk production.
My other favorite breast pump was the Spectra 2. It’s not as easy to work into a pumping bra, but it’s quiet, comfortable, produced well, has more settings than anyone could want, and it’s portable!
It was a much more affordable in-home option than the hospital-grade one I rented for a while.
I also tried the Medela Pump-in-Style, one of the most common breast pumps, and I’m going to be honest, y’all–I loathed it. I tell you this because it’s one of the most common pumps, and because many moms hate pumping. There’s probably a correlation. I wouldn’t have pumped for more than 2 days if I’d been exclusively using that thing.
Decide on the route that’s best for you, micrognathism mama. But if you go the exclusive pumping route, I have to tell you about this one lifesaving product. I learned about it when Jack was about 20 weeks, and I was furious that no one had told me before.
I’m not even kidding, the Kiinde Breast Milk Storage Twist Gift Set will give you back HOURS of your life that would’ve gone into washing bottles.
It comes with adaptors to work with any pump, and has a bottle base that the plastic bag clips into. All you have to wash is the nipple (and your other pump parts). Total game changer.
Note: If you need to turn to exclusively pumping like I did, check out our exclusively pumping tips!
Exercises for Overcoming Micrognathism
According to both my lactation consultant, and the Children’s Hospital of Philadelphia, there are things you can do to help your newborn grow into their recessed chin.
Many people claim that craniosacral therapy can help your newborn’s recessed chin, and that Osteopathic Manipulation Therapy can, as well. If you’re interested in these, look up practitioners in your area.
My lactation consultant said she’d seen these therapies work for some babies for different problems, but that generally, growing into a newborn recessed chin just takes time.
I cannot tell you how much I loved her for saying this. We’d spent weeks that felt like a lifetime doing exercises to try to help Jack latch. I just wanted to be done.
So we settled into the one thing she insisted helped: tummy time.
Jack slept on his back (I’m all about safe sleep practices), but he spent every waking moment possible on his tummy, which pulls the lower jaw forward.
Remember, tummy time doesn’t have to take place on the floor. Your newborn can lie tummy-to-chest on you, or you can do tummy time on your legs. I kept myself reclined as much as possible and held Jack with his tummy on my chest. I’m not going to lie–that’s one of the only parts of the newborn stage I remember loving. It was comforting for us both.
What to Expect When a Newborn Grows Out of Micrognathism
The good news is that, according to Feedingmatters.org, “the majority of infants with a slightly recessed jaw outgrow these feeding concerns. At around 3-4 months of age the infant’s neck elongates and the pharynx deepens as the jaw moves forward with facial growth.” Basically, an infant’s jaw grows rapidly during the first three months.
This means that baby can now move forward with more traditional breastfeeding positions!
If you aren’t breastfeeding, my guess is that you won’t even notice the change as your baby grows out of micrognathism, except that feedings might become faster.
But if you are breastfeeding, this moment is glorious. Oh, the latch!
Jack drank pumped breast milk from a bottle for the first 10.5 weeks of his life. And I suffered through being a mom alone on maternity leave, caring for a newborn and pumping round the clock. I’m glad I did it, but I don’t recommend it.
One night, Jack finished his bottle as we were putting him to bed, but he clearly wanted more. Husband was about to go heat another bag of breastmilk, and I wanted to cry and scream.
“Why can’t I just feed him and fix this?”
So I sat down, pulled the world’s greatest nursing pillow around me, got all set for nursing, and then said, “We both know this won’t work. But let’s just try it anyway.
That sweet baby latched straight to my chest and drank all the milk he needed to be satiated before bed.
I cried and shook. I took a picture. Honestly, I wanted a video, but Husband is a prude and didn’t want the video in the cloud. So I took a photo on my own.
Husband is going to love that I’m posting it here. Like, really love it.
Jack’s latch was shallow, but it was there.
I called Danielle, and she rushed over the next day, helped us perfect the latch, and off we went. My baby nursed, and I was in Heaven.
For most of us, this is the end of the micrognathism journey.
Further Issues You Might Encounter
If your baby is one of the rare ones who doesn’t grow out of a recessed chin, then more severe issues might be at play, such as Pierre Robin Sequence (PRS). However, this condition would likely be diagnosed a birth, as it can result in extreme airway obstruction that is not caused by other problems.
In the case of a recessed chin that causes severe or ongoing breathing trouble, surgery might be recommended by a doctor, but non-surgical methods are usually exhausted before this is the case.
It’s important to remember that most recessed chin issues are cleared up with infant growth. It may be a struggle to feed a baby with a recessed jaw, but just remember that there is a light at the end of that tiny, recessed tunnel!
What were your struggles feeding a newborn with a recessed chin?
General FAQ about Babies with Retracted Jaws
What is a recessed chin?
When a baby’s jaw is undersized, their chin may sit further back, closer to their neck, than the rest of their face.
Why do babies have retracted chins?
Retracted chin is a condition that may be caused due to prematurity, as a baby’s jaw develops in the last three weeks of gestation. In severe cases, a retracted chin is a genetic condition caused by trisomy 13 or progeria.
How do you feed a baby with a recessed chin?
Because babies with recessed chins cannot open their jaws fully, they struggle to latch for breastfeeding. Most newborns with retracted jaws feed most easily with a bottle, but some are successful nursing on their stomachs while mom lies on her back.
Will my baby grow out of a recessed jaw?
Most children outgrow a recessed chin within the first 10-12 weeks, the timeline may vary. On rare occasion, lifelong problems occur.
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Had you ever tried to get your baby to latch before the 10.5 weeks? My son will just lick at it now because he’s gotten lazy from solely bottle feeding.
I did try regularly, with nipple shield, and then once a week once we figured out the problem. The latch just didn’t work, and he wasn’t even getting milk through the nipple shield even though it looked like he was. If I’d been willing to go back to the nipple shield when he was older (like 6 weeks), I think it’d have worked. I think continuing to try to latch him is great as long as it works for your physical or mental health. It was draining me, so I had to quit.
I can relate to your post so much! I think my son had both a tongue tie and a recessed jaw and was also induced at 37 weeks. I had the most difficult time breastfeeding and was exclusively pumping and topping with formula, when my baby was 4 months old his tongue tie was detected, it got released and I was able to breastfeed since. But I think a lot of it could also do with the fact his lower jaw had grown. I don’t think I’ll out myself through pumping again, I had the medela in style pump and it was torture.
I’m so glad he’s nursing now! We also revised a lip and tongue tie (I have both but was bottle fed). The pump-in-style is the WORST, and awful for production. So glad you’re finished with that machine. If you ever need to pump again, look at spectra, but it’s probably not worth the investment at this point.
What didn’t you like about the pump in style?
My supply dropped massively when I started using it, and I had 2 different lactation consultants tell me it’s the worst pump for milk supply.
Thanks for this article, I’ve read it lots of times over the past 9 weeks since my son was born with a recessed chin, tongue tie and high palate. It’s kept me motivated to keep feeding with a nipple shield and topping up with expressed milk in the hope that by 12 weeks he’s able to latch properly. Knowing it’s a real anatomical barrier has also helped me be kinder to myself and my son. There’s surprisingly little about this issue on the internet so i really appreciates this article.
I’m so glad it has helped. Have you revised the tongue tie? We had to revise a tongue tie and lip tie for Jack, and he also had a high palate, but he got there! It means so much to know my story has helped you.
Thank you so much for such a detailed post! My second has a pronounced recessed jaw and early help from a LC saved me. I’m only 1 month in but weight gain is good due to being extremely vigilant about the right position during latching.
And I’m glad to hear that most babies outgrow it relatively quickly! We have home exercises to do but I’m finding it hard to fit them in as feeds are long and then she’s asleep, or I’m trying to get her to sleep.
Anyway; thanks !!
It’s so hard to fit in the exercises! Do what you can if you can, but don’t stress yourself. It’s a hard enough time without that!
Thanks for the detailed info! My LO is 6 weeks and we have been to a LC (they are the best!) 4 times in the last 5 weeks. He has been feeding, but something wasn’t “quite right” with his milk transfer and even the LC had a hard time figuring it out. Finally she and my Ped agreed he has a slightly smaller jaw and maybe asymmetrical.. mostly causing frustration and latching issues on the left (more awkward?). I am doing the whole feeding-pumped milk-formula 3 ring circus. We are starting cranial sacral therapy this week so hopefully it helps! This is a great reminder to increase me tummy time and that there is hope he grows out of it! Thank you for that!!!! 🙂
THANK YOU for writing this. My son has a recessed jaw, high bubble palate and tongue and lip tie and this really gave me some hope. He sees a bodyworker that specializes in craneosacral/osteopathic/myofunctional therapy. We’ve seen some progress but it’s hard when that progress is slow and you’re not sure if it’ll get much better anytime soon. He was born at 38 weeks and was at an angle during pregnancy and had to be manually turned. He is 10 weeks old so I’m hoping that he will grow into his jaw soon. I always worry about his breathing since he snores a lot and absolutely hates sleeping on his back.
What nipple did you find for bottle feeding that was the most helpful?
In the early days, we used the Dr. Brown’s bottles (such a pain, though!) with the slowest flow preemie nipples. Our lactation consultant suggested this so that he would have to work his jaw harder by sucking more. She said that if feedings were taking too long, to move him up to the newborn nipple, but not past it. Once he grew into his jaw and he both breast and bottle fed, we switched to the Kiinde system, which was a game changer in terms of time and washing bottles/pump parts.
Thank you for your post. I’ve struggled with my babies latch, but I noticed her recesses chin right away. I’ve been pumping and supplementing. I’ll be meeting with a lactation consultant to get help with the latch, but it’s good to know it will get better.
I am so glad you shared your experience! We were induced at 37 weeks due to a liver condition and within the first week I knew something was off. He is my 5th baby and all the other kids gained within the first week. This guy was loosing weight. Slight lip tie, but definitely a recessed chin. Thankfully the LC and the ped (who is also a LC) noticed his small chin & tounge quickly. We are at 5 weeks now and there has been slow improvement with latching. This was so helpful to have a more thorough explanation of what and when to expect things. Thank you. 💗
My grandson appears to have a slightly recessed chin. He is now 2 months old, seems nurse fine and is on schedule with weight gain, he is my daughter’s 3rd son. The problem is about 20 minutes after he is fed burped and laid back down to sleep, he makes gurgling, gagging or choking sounds. She will pick him up and pat his back. His breathing sounds wet, garbled and will often cough and spit up again. Occasionally a little will come out of his nose. He experiences less of this happening if he is kept upright. However, she cannot stay up all night holding him upright. Does this seem connected to problems associated with a recessed chin.
I can’t say if there’s a connection; I will say that my son vomited a lot unless held upright (and even a little after), but we never made that explicit connection. I would talk to her pediatrician to be sure!
This article is amazing! First of all, this is literally my baby – a boy named Jack, born at 37 weeks for preeclampsia. Except unlike yours, he was not my firstborn – he’s #4.
Neither of his older brothers (also 37 weekers) was ever able to breastfeed, but no one could really tell me why
– only tried for a few days with #1 before switching to EP x 3 months, then formula for the be remaining 9
– with #2, whom my Jack physically resembles a lot, I unsuccessfully tried breastfeeding for 8 weeks. Burned my whole maternity leave, baby re-admitted to hospital with jaundice due to my refusal to offer any bottles during those early days. I resented my poor babe (who now, at 3 1/2, is my best little buddy). Two different LCs called “posterior tongue tie” on him, but I didn’t agree, didn’t see ENT, and stopped pumping and trying to nurse at 8 weeks, did formula bottles for the rest of the first year
– had such bad experiences with the first 2 that I went straight to formula with their sister, baby #3 (also a 37 weeker, but who did not share their physical features). Refused LC in hospital, gave only formula bottles. Then, just for fun, tried for the first time to latch her at 5 weeks, since covid had just started and I thought she might benefit from antibodies. She latched right on, so I re-lactated, from drops to 17 oz/day, but never got to full supply, and stopped nursing at about 4-5 months due to lack of time to pump at work (MD in covid ICU)
– fast forward to #4, who was born last month, also 37 weeks. Pediatrician told us on day 2 that his recessed chin and high palate would prob make nursing difficult for a while – would you believe that’s the first time in all this that anyone ever mentioned the chin?! LC (of course) called tongue tie, but ENT disagreed, also thought the problem is the chin/jaw so we didn’t clip anything.
Anyway, all this to say that this journey has lasted over half a decade for me, but your article has given me the strength to stick it out pumping and intermittently trying to nurse with shield for a few more weeks before giving up my supply. This is my last baby, and if waiting really gives us the potential to end up nursing for several months, I want to take that chance
From one mama to another, thanks!
I’m so thankful this helped you, mama! FYI My recessed chin baby couldn’t even get milk from a nipple shield. There was milk in it, but he couldn’t drink it, so definitely make sure your Jack doesn’t seem hungry ater! Also, mine had a high palate, recessed chin, AND lip and tongue tie (I also have all but the recessed chin, even today.)
Thank you so much for sharing your story. My daughter is very similar. I’m exclusively pumping but don’t know how to continue that when my husband starts traveling for work again. My daughter cries after 5 minutes of being put down, and most of her day requires hands-on help with eating, burping, soothing, etc. I take 20 to pump and wash. She gets in the way of the pump parts when I hold her and pump. How did you pump and care for your son?
Oh mama, you’re in the HARD times! Do you have family or friends around? That was the only way I got through. I scheduled someone to come as many days as possible at some point just to guarantee a good pump session. And I pumped until empty just to be sure I got a good one in. It may really be worth evaluating if it’s worth it for you. For me, it was, but that’s not always the case and that’s okay.
This article gives me so much hope! My son was born with a recessed chin, lip, tongue, and cheek ties. After numerous trips to the LC, we finally got his ties released and started bodywork but the results aren’t coming soon enough (he’s 6 weeks). We use a nipple shield and SNS for now, and I’ve been pumping in between (goodbye time for anything else). I’ve spent so many sleepless nights searching Dr. Google and crying in the dark reading all of the horror stories! Hearing this story seriously gives me hope that my LO will make it out okay! Thank you so much for this article!
Hi
Thank you for this article.
We are 9 weeks out and I’ve had multiple providers comment on his recessed chin but no one could tell me it was tied to our breastfeeding issues. Even w tongue tie revision and body work- slow progress- this gives me hope. Thank you for sharing!
I am so grateful that you wrote this article and so glad that I was able to read it. I am using nipple shield and pumping for now. I’ve spent so many sleepless nights searching Dr. Google and crying in the dark reading all of the horror stories! Hearing this story seriously gives me hope that my LO will make it out okay! Thank you so much for this article!
Hugs, mama! You’re in the hard times, but it gets easier. Baby will do amazing on your pumped milk, and there’s nothing wrong with supplementing if you need to or choose to do that to improve your own sanity!
My baby was born at 38 week he got a slight case of his jaw line being push back but he latch bottle hood with feeding my concern is when will he grow out of small jaw line he been to ent no surgery recommend yet I’m just concerned
I teared up reading about your Jack latching at 10.5 weeks. Yay! Go Jack!
My son has a mild posterior tongue tie and a mildly recessed chin. We breastfeed but its not the easiest. We are currently looking into body work and I use a shield as needed when I need time to heal. Flipple technique has helped a lot for us!
Our man is five weeks old. Hope we are seeing some improvement soon!
I just came across your article and that is so reassuring to me. My LO was born at 38 weeks and we all thought he had a perfect latch (he was able to latch right away at the hospital). Although it seemed like he was latching well, he wasn’t gaining enough weight. That led me to think that something was wrong with him. We went to the hospital where he had all these exams and blood tests and nothing was detected. At the hospital I pumped the whole time as I wasn’t able to feed him anymore. At the end of our stay we weighed him and he had gained so much weight! He drank really well from the bottle. I went home not knowing what the issue was. I hired a LC and she straight up said he has a tongue tie. I took him to two dentists and they said his tongue tie is so mild that a release wouldn’t improve his latching. One of the other dentists said that his recessed chin might be the problem. I started realizing that that’s what may be the issue. He was the first person to say that. Now I’m pumping 8 times a day and my baby weight is increasing drastically. Since I’m mostly bottle feeding now he doesn’t want to take my breasts at all. I’m hoping one day I’m going to be successfully able to breastfeed my baby. I’m feel so hopeless some days though and I also feel guilty specially because I was starving him in the beginning without knowing.
Thank you for sharing your story. You did your best, mama, with the best information you had. There’s nothing to feel guilty over. I hope he’ll want to latch one day, but right now, he can’t. I stopped trying and tested it once a week until it worked. Maybe that would give you some stress relief?
Considering my busy schedule with a toddler, attempting breastfeeding once a week seems like a reasonable approach. Frustration sets in when I can’t breastfeed due to time constraints during the day. Did you use any medication to boost milk flow? I’m currently pumping eight times a day, yielding 100 to 120 ml per session. Do you remember how much you were pumping?
Your article has given me so much hope. Do you think releasing the ties helped? My baby was diagnosed with a recessed chin and high palate. He has mild lip and tongue tie and also mild laryngomalacia. He was able to latch without a shield around 7 weeks, but still can’t transfer more than 1 oz and then gets tired. We chose not to get the ties released because he has all these other co existing issues, it’s hard to tell what’s causing what and the evidence is shaky and our provider agrees that releasing may not fix the transfer issue. Hoping we turn a corner soon. There was a time when I thought he’d never be off the shield and now he doesn’t need it so that is also promising.
He’s still little and growing into that jaw. It’s soooooo hard when you’re in it, but try to be patient. Remember bottles for breaks are okay. In our case, releasing the ties made no difference. I can’t say for sure if it’d have become an issue later, but my daughter’s ties were similar, but her jaw was normal and her latch was fine. We never released hers.
Thank you so much!!