I have been passionate about helping babies breastfeed for as long as I can remember.
In my current work as an osteopath, I have this privilege every day.
I thought it as good a time as any to share some of my thoughts and experiences around breastfeeding, both personally and professionally.
My story:
On my mother's side of my extended family, I am one of 22 children born to 5 sisters. I'm the second eldest with 2 younger siblings and 19 cousins. I think all of us were breastfed for around 12-18 months.I was fortunate to grow up observing breastfeeding as the norm. It was a constant part of my childhood and adolescence at family gatherings: to see a sibling or cousin breastfeeding on demand.
When I had my first child in 2005, there was never any question about how I would feed my daughter. She would breastfeed. Little did I know how much difficulty she would have in doing so to begin with.
After all, I knew what breastfeeding was all about. I knew more than my mother and aunts ever did as I had studied anatomy & physiology extensively during my osteopathy degree. I had read the information and watched the videos on what correct breastfeeding attachment looked and 'felt' like. Surely I could do this.
My side of the breastfeeding equation was complete: I had breasts with nipples and milk. I had arms to hold my baby close. I had food and fluids to nourish my body. I offered and encouraged my baby to go to the breast often. That's pretty much all a mum needs to do.
But my baby had not quite sorted out her side of the breastfeeding equation.
- she had trouble getting her attachment right (it hurt me a lot)
- she wouldn't open her mouth very wide
- she had trouble coordinating her suck/swallow/breathe pattern
- she kept falling asleep
- she preferred one breast to the other
Q. Did I ask for help from numerous health professionals? A. Yes
Q. Did I get the help I needed? A. Not really
Q. Did I encourage her to keep practicing, learning and trying? A. Yes
Q. Did we succeed in establishing comfortable breastfeeding? A. Yes
Fast-forward a moment to 2007 when my second child arrived.
Ebony & ivory. Chalk & cheese. Night & day.
Both children born at over 41 weeks gestationFirst labour induced, second was not
First labour 8hrs+ and very long second stage (2.5hrs), second labour 2.5hrs start to finish
First delivery I was laying on my back, second delivery I was kneeling
Both had somewhat delayed cord clamping, weighing and measuring (all by choice)
First baby had midwife 'shove' her to the breast, second baby had 3hrs skin to skin and found the breast himself
First baby had significant attachment trouble for weeks (ouch!), poor weight gains, jaundice, and by 4 months only fed from one breast. Second baby lost no weight, no attachment trouble, fed from both breasts (though 7 consecutive weeks mastitis - ouch!)
Both fed until around 18 months of age.
Could these two children and two breastfeeding experiences have been any further apart? No.
Did my experiences and learning with the first baby help me with the second? Absolutely.
Was I motivated to further study a Certificate IV in Breastfeeding Education (Counselling) ? Most definitely.
Was I motivated to further study a Certificate IV in Breastfeeding Education (Counselling) ? Most definitely.
An osteopathic perspective
With time my osteopathic training has led me to observe and analyse the mechanics and physiology of a baby breastfeeding in a whole new way. This was driven by what I noticed when comparing the experiences of feeding my two children, and through my observations in my clinic and in the community.
The more I think about breastfeeding, the clearer it becomes: as mothers we are breastmilk makers who facilitate breastfeeding by making the breast available. Our babies are the breastfeeders who do the work of feeding by removing the milk.
The more people I help with breastfeeding difficulties, the more evident it becomes that it is almost always the baby who is having the problem with getting breastfeeding established, NOT the mother.
As Osteopaths, we are trained to assess the structure of the body and interpret how that structure may affect the function of the systems within the body.
Remember, the ‘work’ of breastfeeding is done by the baby.
This new skill they have to learn takes time and practice.
If the pregnancy or labour has been particularly difficult or of high intervention; the physical stress on baby’s body is also high.
Baby’s head often takes the worst of the strain which
can affect the jaw, palate, throat, neck and tongue – all of which are essential to competent breastfeeding. The shoulder may also be involved.
Strain or pain experienced in these areas may be evident if you notice any of the following in your baby:
- Difficulty sucking or latching
- Fatigue from effort at the breast
- Trouble coordinating suck, swallow & breathe
- Inadequate opening of the jaw (often leading to poor attachment and increasing the chance of nipple damage for mother).
- Baby uncomfortable at the breast (squirming, refusing, distress)
As a baseline, the jaw, neck and shoulders need to experience movement; the jaw, tongue and throat muscles must develop strength; the coordination of the action of suck/swallow/breathe takes nervous system development; the muscle tone in the gut must mature and the intestinal flora must grow and mature to digest the milk.
Extra factors to consider are: any residual effects from drugs given to mother in labour, the nature of delivery (length, interventions, prematurity); impact from any other feeding methods used; any separation of mother and baby; any concurrent health issues present; means of support and information available to the family; and the ability to access or afford specialty lactation support.
Helping Babies Breastfeed
In my day-to-day work as an Osteopath, I have new parents arrive in an often painful, sleep-deprived, exhausted, confused state. Baby is frequently much the same.
So what do I do to help?
I begin by taking a case history, as I would for a new patient of any age with any of the variety of reasons for attending for treatment.
I ask about the birth and what has been happening in the time between then and now.
I ask about the way baby behaves, the way he/she moves or lies, feeds, sleeps, squirms,digests and the way he/she communicates.
Things such as ease of dressing/undressing; preferences for lying on their back or tummy; liking or disliking movements; quality of sleep rather than duration all show very important clues to reasons behind baby's feeding difficulty.
Examination is usually conducted with me gently holding baby in my lap. I feel their muscle tension, the way various parts move (spine, shoulders, and limbs). I may palpate their abdomen to asses gut tension and straining effort if present.
Next, I'll usually lie baby on the treatment bed and observe the way they stretch and wriggle; looking for any obvious asymmetries or areas that seem to require further assessment.
Sometimes I'll also feel inside baby's mouth to assess the tongue, palate and lips.
Observing and palpating baby's head, neck and jaw is often best done during a feed where I can also assess the coordination of suck/swallow/breathe.
Treatment then progresses quite subtly with more purpose behind the movements performed, or points of contact selected. The focus is very much on keeping baby comfortable and for me to be carefully working with your baby's body to facilitate change in the tissues. It is not about me forcing it to change or using more than the most gentle pressure.
Very often, much of the treatment can be done whilst baby is feeding or being held in your arms.
I discuss my findings and aims of treatment with mum (and dad/grandma/aunt or whomever is in attendance and involved). I am happy to answer your questions along the way. I enjoy getting to know how you (mum) are coping too and how your body is recovering from the pregnancy and birth. I can provide you with suggestions and advice on how to manage your breast health, your milk supply, expressing milk etc.
The number and frequency of follow-up appointments will depend on your baby's age, complexity of the problem and other supports in place. It is always my aim to give you the best results in the fewest sessions. However rapidly growing babies are not always easy to predict so we do need to watch their progress and be flexible along the way.
You can also be assured that if I identify something I think is beyond my osteopathic ability to help with, then I will refer your baby as necessary to a more suited professional.
Next, I'll usually lie baby on the treatment bed and observe the way they stretch and wriggle; looking for any obvious asymmetries or areas that seem to require further assessment.
Sometimes I'll also feel inside baby's mouth to assess the tongue, palate and lips.
Observing and palpating baby's head, neck and jaw is often best done during a feed where I can also assess the coordination of suck/swallow/breathe.
Treatment then progresses quite subtly with more purpose behind the movements performed, or points of contact selected. The focus is very much on keeping baby comfortable and for me to be carefully working with your baby's body to facilitate change in the tissues. It is not about me forcing it to change or using more than the most gentle pressure.
Very often, much of the treatment can be done whilst baby is feeding or being held in your arms.
I discuss my findings and aims of treatment with mum (and dad/grandma/aunt or whomever is in attendance and involved). I am happy to answer your questions along the way. I enjoy getting to know how you (mum) are coping too and how your body is recovering from the pregnancy and birth. I can provide you with suggestions and advice on how to manage your breast health, your milk supply, expressing milk etc.
The number and frequency of follow-up appointments will depend on your baby's age, complexity of the problem and other supports in place. It is always my aim to give you the best results in the fewest sessions. However rapidly growing babies are not always easy to predict so we do need to watch their progress and be flexible along the way.
You can also be assured that if I identify something I think is beyond my osteopathic ability to help with, then I will refer your baby as necessary to a more suited professional.
Helping babies breastfeed is a part of my job that I absolutely love!
