Breastfeeding Difficulty — Chiropractic Children's Healthcare

Do you have difficulty breastfeeding your baby?

We may be able to help.

We understand the importance of breastfeeding; with the World Health Organisation (WHO), the American Academy of Pediatrics (AAP), and the National Health and Medical Research Council (NHMRC) recommending exclusive breastfeeding for the first six months of life, followed by breastfeeding with the introduction of nutritious complementary foods, until at least one to two years or beyond (World Health Organization 2011; American Academy of Pediatrics 2012; National Health and Medical Research Council 2013).

We also understand that exclusive breastfeeding has many benefits including improved infant survival rates, health, growth and developmental outcomes for the infant (World Health Organization 2011). In addition to the benefits for the infant, breastfeeding also provides physical and psychological benefits for the mother.

The Australian Government has strongly supported the practice of breastfeeding, with frequent surveys, inquiries, and strategies culminating into the “Best Start Report” (House of Representatives, Standing Committee on Health and Ageing2007; Australian Institute of Health and Welfare 2011. 2010).

A major factor behind these breastfeeding initiatives and reports is the low rate of exclusive breastfeeding at 4- and 6-months of age. In Australia, at birth, 90% of mothers are exclusively breastfeeding their child.

The thing is though, not everything goes to plan.

The rate of exclusive breastfeeding reduces to 46% at 4-months of age and 14% by 6-months of age (National Health and Medical Research Council 2013).

So what has happened?

Well in 2013, a research team from the USA looked at the common reasons for premature cessation of breastfeeding and found difficulty with latch and sucking to be one of the most common reasons given.

But what can cause difficulty with latch and suck?

In a paper published in Breastfeeding Review – the Journal of the Australian Breastfeeding Association – Drs Christian Fludder (Chiropractor) and Jenelle Bourgeois (Chiropractor) stated “one factor gaining support as a possible contributor to difficulty with latching and/or sucking is disruption to normal biomechanical function of the cervical spine”. The chiropractor plays an important role in improving breastfeeding rates by providing: maternal education of the benefits of breastfeeding, nutritional advice, appropriate collaborative care, and with appropriate treatment where indicated.

“one factor gaining support as a possible contributor to difficulty with latching and/or sucking is disruption to normal biomechanical function of the cervical spine”

Now we do need to clarify that this paper is only a single case study, and even the authors acknowledged this as a limitation, but thankfully researchers have been active in this field. A 2018 review of manual therapy and breastfeeding difficulty was able to conclude there was “a moderate level of favourable evidence supporting manual therapy for infants with musculoskeletal dysfunction and suboptimal breastfeeding”. Further on this, a 2019 survey-based observational study found a “statistically significant and clinically favourable outcome from manual intervention”.

So there certainly is evidence that manual therapy may be able to aid those with “musculoskeletal dysfunction” and breastfeeding difficulty.

In fact, it may be this evidence that helps parents make their decision to see a chiropractor in the first place; a public survey of more than 21,000 parents showed than 99.7% had a positive experience with the care of their children, and 98% indicating that their child improved after treatment!

So could there be a reason for your baby’s breastfeeding difficulty?

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Common Indicators:

Difficult attachment

Arching (extension) type movements of the neck/body when trying to latch. This can occur on both sides (bilateral), or only one side (unilateral). These babies are often unsettled, have poor swallow, and/or a head preference/head asymmetry/plagiocephaly. Other symptoms may appear "reflux" like.

Arching or shaking fussiness

Once attached, two specific patterns may occur.

1. Arching (extension) movements as described above, or

2. Side-to-side (shaking) movements. Arching on one side and shaking on the other can occur. Babies with the shaking pattern will often have poor sleep regulation (poor settling and frequent waking).

General Fussiness

General fussiness occurring only on one side with pain, crying and pulling off, which starts after attachment and continues throughout the feed. These babies are often unsettled, with poor sleep, hate/dislike tummy time and dressing. Poor suck and swallow Suck dysfunction may include poor tongue movement, mouth movement, rooting/sucking reflexes, and clicking noises. A very strong suck (the “chomper”) that hurts the nipple can occur due to pain. Other signs include excessive choking, gagging and coughing. Falling asleep at the breast Certain specific problems can affect arousal levels, thus affecting full completion of feeds.

A combination of multiple patterns

The above patterns are typical of specific body dysfunctions, and when only one dysfunctional area is present, the pattern is relatively simple to identify. It is very common to have multiple combinations of these patterns, or variations of these patterns, which must be recognised for resolution of the breastfeeding difficulty, and thus continuation of feeding.