Breastfeeding a Tense Baby: How the Vestibular System Plays a Role

An Overlooked Root Cause of Infant Tension and Breastfeeding Struggles: Sensory Challenges, particularly the vestibular system.

The vestibular system helps baby respond to movement- think laying down for diaper changes, rolling into tummy time, being held upright against parent's chest- these movements build balance, strength, and lay the foundation for later milestones, like rolling and sitting. Sometimes tension is a sign that baby's body interprets movement as a threat. You may notice that they hate diaper changes, tummy time, or carry a lot of tension, particularly through the shoulders and neck.

Think of a trust fall. If you were to cross your arms over your chest, close your eyes and fall backward into the unknown- would you be light as a feather, or would your whole body tense up, and your heart race as you brace yourself? I imagine this is what baby experiences when their vestibular system is challenged. Movement is scary. They brace for the impact.

While we frequently talk about the more obvious causes of breastfeeding challenges: impaired oral motor skills, tethered oral tissues, and body tension; the vestibular system plays a foundational role in feeding.

How Vestibular Challenges Show Up as Tension

Infant tension is rarely random. From a neurodevelopmental perspective, it is often adaptive—a strategy the nervous system uses to feel safe and stable. When vestibular input feels unreliable or threatening, the body may respond with:

• Arching, stiffness

• Jaw and oral tension

• Limited head rotation or strong positional preferences

• Difficulty settling or frequent startle responses

• Poor tolerance for movement

In these cases, tension isn’t the primary problem—it’s the symptom.

The Feeding Connection

Feeding is very demanding on the vestibular system. It requires:

• Stable head and trunk control

• Accurate grading of movement

• Coordination of rhythm and timing

• The ability to stay regulated while the body is being moved and repositioned

  
  

When the vestibular system is under stress, feeding may look like:

• Clicking or loss of seal at the breast or bottle

• Clamping or biting behaviors

• Disorganized sucking patterns

• Fatigue early in feeds

• Preference for one feeding position or side

This is why infants continue to struggle even after oral ties are released or bodywork is done—the nervous system still doesn’t trust movement.

Why Traditional Approaches May Fall Short

Manual therapies also known as "bodywork", or feeding therapy that only looks at the mouth, may not fully resolve tension and feeding challenges if vestibular integration is not addressed. Without nervous system safety, the body often returns to familiar protective patterns.

This can feel frustrating for both clinicians and families:

• “We’ve tried everything.”

• “It gets better for a few days, then regresses.”

• “They’re strong, but still unhappy.”

These patterns often point upstream—to sensory processing rather than structure alone.

A Whole-System Lens

When we view infant tension through a vestibular lens, we move away from asking, “Where is the tightness?” and instead ask, “What is the nervous system responding to?”

This shift allows for:

• More sustainable progress

• Fewer cycles of tension and release

• Greater compassion for the infant’s experience

• Clearer collaboration across disciplines

  
  

Tension is communication. When we listen through a sensory-informed framework, we can support infants not just in relaxing—but in organizing their bodies for growth, feeding, and connection.

If you’re a parent or provider noticing persistent tension despite intervention, it may be time to look deeper than muscles alone.

At Nourish Feeding Therapy, we view feeding through a whole-body, nervous-system–informed lens. While oral skills matter, they don’t exist in isolation. Feeding depends on how an infant’s body organizes movement, posture, and regulation—and the vestibular system plays a central role in all three.