Careful observation will often give clues as to what is going on.

Does the coughing happen as soon as the baby is put in a bf position? As 
soon as baby latches? When MER starts?

Does the baby's respiratory pattern change when laid on this side? Does 
the baby's color change (especially around the mouth and eyes, and in 
the hands and feet.)

Does the baby have any stridor? Increasing nasal congestion during sucking?

Does the baby choke when put to the problem breast in different 
positions, such as a straddle or kneeling position?

At this age, it could be anything from a unilateral respiratory issue, 
foreign body aspiration, or just a higher supply on this side and baby 
is now mature enough to show signs of difficulty handling flow (little 
babies are likely to aspirate silently, without coughing or choking 
sounds). Does baby have a history of repeated respiratory or ear 
infections? (Though this is less common in bf babies who aspirate).

If you can observe very carefully and share your observations, we might 
be able to help online.

It's never inappropriate to refer to an OT or feeding therapist if a 
baby is having feeding issues that can't be fixed with management 
changes. Refer away, and go along if you can.

Catherine Watson Genna, IBCLC  NYC

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