Babies with breastfeeding challenges are common in chiropractic offices. Obviously, we need to respect and support parents in whatever decision they make about feeding their baby, but if their choice is breastfeeding, it is essential we know how to help them be successful. Below are some pearls to support your adjustments with these little ones.

Benefits of breastfeeding for Bub and Mum

Breastmilk is universally recommended as the best nutrition for a baby. WHO estimates that increasing breastfeeding to near universal levels would save 800.000 lives per year, mainly in babies under six months, as well as lowering the number of mothers developing breast cancer, ovarian cancer, type 2 diabetes and heart disease (1). The benefits of breastmilk for baby includes improved immune foundation, reduced risk of infections and less hospitalisations. Breastfeeding decreases the risk of SIDS, colic and allergies, increases the IQ of the baby and improves bonding between mother and baby (2).

Breastmilk list of Ingredients

Breastmilk is the perfect food for babies, containing an ideal combination of proteins, fats, carbohydrates, immunoglobulins, vitamins, minerals, oligosaccharides, microbes and lactoferrins to suit the individual baby here and now. The colostrum (the substance produced in the breast before the milk comes in) contains live stem cells for building baby’s brain, liver, bones, etc. The colostrum also has proteins which coat the intestinal tract, plugging the gaps to prevent harmful bacteria from crossing into the blood stream. The combination of nutrients in breastmilk changes as the baby gets older, from start to finish of a feed and from morning to night, with higher melatonin levels in later feeds. Breastmilk is even different depending on gender!!! If the baby is unwell, the immune status of the baby is transferred to mum through ducts at the areola when baby is feeding, facilitating mum to produce milk that contains exactly the correct composition of antibodies for the sick bub.

What can you do to help breastfeeding challenges?

When we as chiropractors encounter a baby who has difficulties breastfeeding, consider:

Is there a preference for turning the head in one direction when sleeping or resting? Does baby prefer one breast? Is the baby assuming an extension posture? These may indicate upper cervical subluxation and dural tension with possible uneven feeding capacity, poor latch, poor tongue function and difficulty coordinating the suck/swallow/breathe rhythm.
Does baby appear floppy and have difficulty lifting the head when on the tummy? This could be a baby with low tone. If so, everything baby attempts to do is going to be hard, including breastfeeding, and baby may be exhausted. Beware that low tone can be a sign of significant neurological, metabolic or muscular issues. If in doubt, consult one of your local paediatric colleagues.
Are there tethered oral tissues, such as a tongue tie? Do they impact function requiring surgical release or are you able to manage conservatively with adjustments and stretches?

Feeding posture

Sometimes breastfeeding challenges can be improved significantly just by changing baby’s feeding posture. The traditional cradle-hold with baby on mum’s arm laying horizontally across her body does not give baby a lot of control. The gravitational force of the milk when let-down occurs may be quite overwhelming and cause baby to struggle to breathe. Breathing is obviously always a priority! Often to help baby latch in this position, mum will hold the head and place the neck into extension, inducing a positional Moro/startle reflex. This may fire a sympathetic NS state of fight and flight, which is not the ideal state to feed or digest.

Straddle feeding

A feeding posture which may allow baby more control of the milk volume and mum to feel more relaxed, is the ‘straddle position’: Mum reclines to about 45 degrees propped up comfortably by pillows. Baby is vertical, parallel with mum’s body, laying tummy to tummy, preferably skin to skin. Baby’s head is voluntarily extended and supported by mum’s hand, the chin is down and the nose free to breathe. In this position baby is able to utilise their primitive reflexes to feed (breast crawl, stepping, rooting, palmar, sucking, swallowing), ‘exercising’ both their brain and body. Baby can control the milk flow as it is not passively forced by gravity, and can easily move the head as necessary. In addition, they can see mum’s eyes to help bonding. For mum, the laid-back position is much more comfortable, with less strain on the neck and shoulders. This position also stimulates the sacrum, thereby increasing vagal response and oxytocin release to help milk production.

Breastfeeding may not be your thing, but saving lives is, right? Thanks for everything you do to help the next generation flourish and thrive.

Dorte

REFERENCES:

1/ WHO 9/2019 https://www.aa.com.tr/en/health/breastfeeding-saves-800-000-lives-each-year-who/1547828

2/ Core curriculum for lactation consultants Manner, 2016

RESOURCES