Breastfeeding Difficulties
November 17, 2018
Breastfeeding offers numerous benefits, including improved nutrition, enhanced immunity, cognitive development, reduced morbidity and mortality, pain relief, cost savings, lower allergy risks, and better jaw development and dental health. Exclusive breastfeeding is recommended as the optimal feeding method during the first six months.
Despite these benefits, 60% of mothers stop breastfeeding earlier than planned. Various factors contribute to early cessation, including maternal, infant, societal, and environmental influences. Infant-related issues are significant contributors to breastfeeding difficulties, with common problems including trouble with sucking or latching (26%), self-weaning (26%), nipple issues (20%), and pain (15%).
These infant-related factors can also impact other critical aspects such as perceived milk supply, maternal satisfaction, pain, confidence, and the desire to continue breastfeeding. For example, milk stasis, which is often linked to mastitis, can be exacerbated by issues with attachment and side preference.
Chiropractic care has been reported to help with breastfeeding difficulties. One case series study involving 114 infants with suboptimal breastfeeding found that all showed some improvement with chiropractic care. Within 2-5 visits over two weeks, 78% of these infants were able to exclusively breastfeed. Common findings included cervical posterior joint dysfunction (89%), temporomandibular joint (TMJ) imbalances (36%), and inadequate suck reflex (34%).
Dr. Adam Stewart conducted a study at Chiropractic Children’s Healthcare with 19 mothers and their babies experiencing breastfeeding issues. The study aimed to:
- Assess the response to chiropractic care.
- Determine the prevalence and specific patterns of subluxation (joint dysfunction).
- Evaluate the effects of specific subluxation patterns on breastfeeding behavior.
Improvements in breastfeeding were observed in every participant. Notable improvements were seen in breast attachment (100%), arching (94%), shaking (88%) once attached, overall feeding stress (84%), pain during feeding (77%), and side preference (64%). Common problem areas included the upper cervical, shoulder, sacral, elbow, and wrist regions, as well as TMJ and cranial dysfunctions. Plans are underway to seek funding for a larger study involving 80-100 babies.
Common Indicators:
- Difficult Attachment: Problems with attaching to the breast, including arching movements (extension) of the neck or body when attempting to latch. This can be bilateral or unilateral and is often associated with unsettled behavior, poor swallowing, and head preference or asymmetry. Symptoms may resemble reflux.
- Arching or Shaking Fussiness: Two specific patterns may occur once attached:
- Arching movements.
- Side-to-side shaking movements, with arching on one side and shaking on the other. Babies with shaking patterns may experience poor sleep regulation, including frequent waking.
- General Fussiness: Persistent fussiness on one side with pain, crying, and pulling off during feeds. This can lead to unsettled behavior, poor sleep, aversion to tummy time, and issues with dressing. Poor suck and swallow can include inadequate tongue movement, mouth movement, and sucking reflexes, or a painful strong suck. Other signs may include excessive choking, gagging, and coughing. Problems with falling asleep at the breast can affect feed completion.
- Combination Patterns: Often, multiple patterns or variations are present, complicating the identification and resolution of breastfeeding difficulties. Recognizing and addressing these combinations is crucial for successful breastfeeding.
- Additional Issues: Mastitis, tongue-tie, low milk supply, and maternal stress can further complicate breastfeeding. In such cases, referral to a lactation consultant or maternal-child health nurse may be necessary.
References:
1. Leung, A. and R.S. Sauve, Breast is Best for Babies. Journal of the National Medical Association, 2005. 97(7): p. 1010-1019.
2. WHO, The Optimal Duration of Exclusive Breastfeeding, Report of the expert Consultation of the Optimal Duration of Exclusive Breastfeeding, Geneva, Switzerland, March, 2001.
3. Odom, EC et al. Reasons for Earlier Than Desired Cessation of Breastfeeding Pediatrics 2013;131:e726-e732
4. WHO, Mastitis; Causes and Management, Department of Child and Adolescent Health and Development, Geneva, 2000
5. Miller, J.E., et al., Contribution of Chiropractic Therapy to resolving suboptimal breastfeeding: A case series of 114 infants Journal of Manipulative and Physiological Therapeutics, 2009. 32(8): p. 670-674.
6. Stewart A. Paediatric Chiropractic and Infant Breastfeeding Difficulties: A pilot case series study involving 19 cases. Chiropr J Aust: 2012 Sept 2012 (42:3): 98-107