What Is the Role of Physiotherapists in Breastfeeding and Infant Feeding?
By: Nataliya Zlotnikov, HBSC, MSc

Know Your Role

As a physiotherapist, do you know what your role or scope of practice is in breastfeeding and infant feeding?

If you don't, don't worry, you are not alone.

The above question is the one most commonly asked of Mercedes Eustergerling (Bkin, PT, Lactation Consultant).

So let us address that elephant first.

What Is the Physiotherapist’s Role in Breastfeeding and Infant Feeding?

Anytime we talk about breastfeeding we are talking about two people working together, the mother and the baby, it's a team effort. 

As physiotherapists, we can help with issues or conditions that arise on the maternal (breast) side of things, and on the infant side of things. 

When it comes down to it, the physiotherapist's role is not about what or how much (nutrition) gets into the baby’s belly, but rather how it gets in (mechanics).

Breast & Nipple Conditions 

A variety of symptoms can present pretty commonly throughout the lactating journey. Some of these are appropriate for a physiotherapy intervention, while others need to be referred out.

Physiotherapists are well-equipped to deal with inflammation, skin integrity and pain within our scope of practice.

The breasts are a part of the woman, they are made for lactating. And so, we need to look at the body as a whole. 

We are doing a great disservice if we say "Hey, we’ll treat all of you except this one body part."

It is also important to note that pain and tissue damage at the nipple can present differently than in the breast.

Inflammation

• The lactating breast can become inflamed, leading to impaired function.
• If the function is impaired by tissue inflammation, we are well-equipped to address it. We already do this for a variety of conditions that involve inflammation.
• The restoration of optimal function is a physiotherapist’s primary mandate.

Skin Integrity

• Physios are trained to maintain and repair skin integrity (nipple skin damage can happen during breastfeeding).
• We understand the effect of excessive pressure (bedsores, diabetes, fitting sports equipment, wheelchair design). 

 Pain

• Physiotherapists are very familiar with treating pain. It is one of our specialties.
• We understand that there is a whole human in front of us and take a biopsychosocial approach to the treatment of pain.

To learn more about the conditions affecting the breast and nipple during breastfeeding and how we can help, take a look at Mercedes Estergerling's complete online healthcare course. 

Click Here for the Full Course!

Here's a short video from the course in which Mercedes discusses Maya Bolman's therapeutic breast massage. 

This technique can be beneficial for mothers experiencing breast engorgement, plugged ducts, mastitis as well as chronic breast pain.

Therapeutic Breast Massage

In This Online Course, You’ll Learn:

• Infant feeding support
• The difference between chest-feeding, breastfeeding, pumping, and supplementing nursing system
• Breast conditions and inflammation
• The biopsychosocial approach model and how to apply this in each session with patients
• Intervention options and how to apply them
• The role of physiotherapists in infant feeding support
• Clinical practice guidelines for special pediatric populations
• New research and upcoming courses.
• Infant conditions, including:
  • Infant reflexes 
  • Orofacial anatomy 
  • Torticollis and MSK
    
    

Important: Breastfeeding & Cancer

It’s always important when we are looking at women and their breasts to keep in the back of our minds that a lactating woman can develop breast cancer.

What Breast Cancer Can Look & Feel Like

Image source: The Independent

To read more about physiotherapy's role in cancer care, take a look at our blog, Physical Therapists Make Life Worth Living: Physiotherapy in Oncology, based on Marize Ibrahim's, physical therapist in cancer rehabilitation, webinar.  

Infant Conditions: From Pain Science to Neuro

One of the most common reasons why milk doesn't come out very well is actually the infant mechanics at the breast.

Infant mechanics in a neonate are largely driven by reflexes.

When we are looking at feeding mechanics we need to remember that the orofacial anatomy differs between the baby and adult. For example, babies have a much larger tongue that occupies more of their oral cavity.

Something that comes up often in the physiotherapy care of infants is torticollis.

Infant Torticollis & Breastfeeding 

Congenital muscular torticollis (twisted neck or wry neck) is a condition in which an infant holds his or her head tilted to one side and has difficulty turning the head to the opposite side (OrthoInfo, 2021).

Infant torticollis can be caused by position in utero, birth, as well as positioning post-natally amongst other things. 

Torticollis can impact breastfeeding and can make it harder to feed on one side depending on the range of motion restriction.

Torticollis can also influence whether the jaw is able to protrude or if the baby chomps or bites at the breast or bottle.

Oftentimes, when we are looking at conditions such as torticollis, it's important to consider if they impact the baby’s ability to participate in functional feeding, whether that be at the breast, or at the bottle.

Torticollis or Tongue Tie?

Torticollis can look a lot like tongue-tie (ankyloglossia). Oftentimes, what people think is tongue-tie is actually torticollis.

Proper diagnosis of torticollis might lead to a decreased need for frenotomies!

Image source: Mayo Clinic

Click Here for the Full Course!

If you enjoyed this course as much as we did, we invite you to take a look at another one of Mercedes Eustergerling's online healthcare courses on Embodia:

Babies, Breasts, and Brains.

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Date written: 5 May 2021
Last update: 26 May 2021