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Breastfeeding and Physiotherapy

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Physiotherapists can be a valuable resource for women who want to breastfeed. They can help them learn how to position their babies and latch onto a breastfeed.

Medically reviewed by

Mohammed Wajid

Published At January 18, 2023
Reviewed AtFebruary 28, 2023

Introduction

The act of breastfeeding is natural but does not always come easy. Many women struggle with breastfeeding and feel like they need help. That is where physiotherapy can come in. Physiotherapists are trained to assist women with breastfeeding, from latch to positioning to milk production. They can provide much-needed support and guidance for women struggling to breastfeed. If they are thinking about starting to breastfeed or are having difficulties breastfeeding, consider seeking out the help of a physiotherapist. Here is what one needs to know about the role of physiotherapy in breastfeeding.

The American Academy of Pediatrics recommends that mothers breastfeed their babies exclusively until they are at least six months old and then continue nursing them until they are at least 12 months old or older if they choose to do so. But even though breastfeeding has many health benefits, not all women can nurse their babies how they want to. However, prenatal classes can help inform women about the health advantages of breastfeeding, both for babies and mothers, and instructors can explain to women the process and techniques they can use to breastfeed effectively.

In today's society, many people lack knowledge about the importance of breastfeeding. Many people view breastmilk as nothing more than something necessary for a baby's survival and not something that has health benefits for both mother and child. However, breast milk has health advantages for both mother and baby, which can be explained in prenatal classes.

What Is the Importance of Breastfeeding?

Breastfeeding is an essential process for both mothers and babies. It helps to build a strong bond between them, provides essential nutrients for the baby, and helps to protect the baby from illnesses. Physiotherapy in breastfeeding supports mothers in achieving a good latch, position, and attachment of their baby to the breast. They can also help with any pain or discomfort associated with breastfeeding.

Breast milk has the perfect composition for babies to grow and develop. Exclusive breastfeeding for six months protects against ear infections, diarrhea, respiratory tract infections, and eczema. Breast milk also contains immune factors that protect against bacteria and viruses, so mothers can breastfeed even when they are sick or have an infection like a cold sore.

Mothers who breastfeed exclusively are less likely to develop breast cancer later in life than women who do not breastfeed or give their baby formula. And exclusive breastfeeding for 12 months lowers the risk of developing type 2 diabetes by as much as 40 %.

In addition, exclusive breastfeeding helps infants to be able to regulate their body temperature better than if given formula and allows them to maintain their food intake more efficiently. Nursing is essential on demand rather than the schedule for health reasons and bonding with the mother.

What Are the Benefits of Breastfeeding?

There are many benefits to breastfeeding for both mother and child.

  • Benefits of Breastfeeding in Babies:

    • Strong mother bonds with her child.

    • It helps the child develop a healthy immune system.

    • It is easy to digest for the baby and can help reduce the risk of certain illnesses, such as gastrointestinal infection, pneumonia, sudden infant death syndrome, malocclusion, and diarrhea.

    • Reduced risk of obesity and diabetes.

    • Supports healthy development of the brain.

  • Benefits of Breastfeeding In Mothers:

    • Breastfeeding can help the mother lose weight post-pregnancy.

    • Lower the hemorrhage frequency (postpartum hemorrhage); it may reduce her risk of developing breast cancer, ovarian and endometrial cancer.

    • Breastfeeding may also reduce expenses (formula milk is costly if the child is not breastfed).

    • Helps delay a new pregnancy.

What Are the Constitutes of Breast Milk?

Breast milk comprises water, fat, protein, carbohydrates, vitamins, and minerals.

Milk Composition

Quantity/100 Ml

Carbohydrates

7 g

Fat

3.5 g

Protein

0.9 g

  • The composition of breast milk changes throughout a feed and over a day. For example, breast milk produced at the beginning of a feed is called foremilk. It is bluish-gray, lower in fat than the milk produced towards the end of a feed, somewhat creamy in color, and fulfills the hunger called hindmilk. Therefore breastfeeding should be done for at least 15 to 30 minutes to help baby weight gain.

  • The composition of breast milk also changes over a day. For example, morning milk has more protein than evening milk. Nighttime milk has more fat than daytime milk.

  • The composition of breast milk also varies from woman to woman and from baby to baby. Some babies may be allergic to specific proteins in breast milk, which can cause gastrointestinal problems such as diarrhea or vomiting.

How Much Quantity of Breast Milk Have Produced?

An individual's breast milk production is correlated to their dose-response relationship - the more babies are fed, the more milk a woman will produce. Therefore the positive response of breastfeeding within 24 hours on milk production on days three and five after baby birth. Colostrum is the first breast milk produced in the first two to three days after delivery. On the first day, it is produced in small amounts, about 40-50ml. Later on the third day, an infant takes about 400 to 500 ml within 24 hours, and on the fifth day, it is about 500-800ml. It is high in antibodies and has been shown to have several health benefits for both mother and baby. It also helps increase an infant’s immunity from illness. It can take up to six weeks after birth before colostrum is replaced by mature breast milk. It is essential for mothers who want to breastfeed their infants exclusively for the first six months of life to continue producing enough colostrum during pregnancy.

What Are Breastfeeding Holds and Positioning?

An important aspect of breastfeeding is positioning and attachment. Good latch points are

  • When the baby's mouth is open wide.

  • Lips are flanged out and covered one to two inches below the nipple.

  • The tongue touches the bottom teeth, and the chin is pressed into the breast.

  • When a woman with a good latch point will likely produce enough milk for her baby. Poor latch points are

  • Pressing down the breast near the baby’s mouth.

  • Baby being too close to the breast so that the baby's nose is covered with breast tissue.

  • Baby's chin pulled down.

  • Insertion of a finger into the corner of the baby’s mouth

Poor latching leads to pain in the breast, nipple pain, or even blocked ducts that lead to infections.

Learning about breastfeeding during prenatal classes can help women prepare for this type of information and help them get their babies off to a good start in life with proper nutrition.

What Are the Checkpoints for Mothers During Breastfeeding?

  • Mother should be relaxed and comfortable with good posture and correct body alignment.

  • Mothers’ arms and backs should be well supported.

  • Supported Baby’s head and body in a proper manner.

  • The baby’s head should be at the breast level of the breast.

  • Baby’s ears, shoulders, and hips should be straight.

  • Chest-to-chest positioning means the baby's chest is facing toward the mother's chest.

  • The baby’s nose is facing toward the nipple, and the chin should touch the mother’s breast.

What Are the Positions of the Baby During Breastfeeding?

1. Cradle Hold

It is the easiest and most commonly used position comfortable for both mother and baby in which the mother supports the baby's head on forearms. The baby's body is facing the mother. It is well-worked for full-term babies who were delivered vaginally.

2. Cross-Over Hold or Cross Cradle or Transitional Hold

This position differs from cradle hold in that mothers do not support the baby’s head with forearms; instead, the mother's arms switch roles. In this situation, if the infant is feeding from the right breast, the mother holds the baby with the left hand and vice versa.Turn the baby’s body, so his and her chest and tummy face the mother directly by placing the thumb and fingers behind the baby’s head and below the ears, guiding the baby’s mouth to the mother’s breast. This position works well for small infants and babies who have latching trouble if the baby is premature and has low muscle tone or if the infant has a weak rooting reflex.

3. The Clutch or Football Position

In this position, the mother's hand and wrist support the baby's neck, back, and shoulders. Lay the infant's back against the mother’s arm. The nose of the infant should be close to the nipple, while the baby’s face should be toward the mother. On the other hand, it supports the breast. This position also supports mothers who have had a cesarean, as their babies can reach out to them more easily.

4. Side-Lying Position or Reclining Position

Mother and baby lie side by side, facing each other. The neck and back are well-supported and comfortable. The baby's chest should be facing the mother. Place a pillow or rolled-up blanket behind the baby's back for support. This position is usually not recommended because milk can enter the ear and cause frequent acute suppurative otitis media (ASOM). Still, it is best for the mother who had a cesarean birth in which the mother feels the pain to sit, wants to rest during night breastfeeding, or has a large breast.

5. Upright Position

This position is helpful for older infants who want to feed sitting bolt upright due to congestion or an ear infection. While using the pillow, sit the infant on the lap, towards the mother, and bring babies head towards the breast.

What Is the Role of a Physiotherapist In Breastfeeding?

  • Many mothers breastfeeding their babies may not be aware of the role that physiotherapy can play in helping them achieve a successful breastfeeding experience. Physiotherapy can help with several issues that can arise during breastfeeding, such as nipple sore, mastitis, plugged ducts, and engorgement.

  • It is well understood that suitable attachment and positioning of the baby at the breast is vital for successful breastfeeding. Sometimes, however, a mother may need help to achieve this.

  • A physiotherapist can assess the mother and baby to identify any factors contributing to poor attachment or positioning. They can then provide specific exercises and advice to help improve the situation.

  • In some cases, a mother may have difficulty producing enough milk. Again, a physiotherapist can offer specific exercises and advice to help with this. They may also be able to suggest other interventions, such as using a breast pump, which can help increase milk production.

  • Overall, physiotherapy can be beneficial in ensuring successful breastfeeding for both the mother and baby.

Conclusion

Breastfeeding is a natural way to feed the baby with many benefits. The American Academy of Pediatrics recommends breastfeeding for at least the first year. Women who breastfeed may experience less postpartum depression, lower risk for certain types of cancer, and decreased risk for type II diabetes. It is essential to have the right support system so mothers are confident about starting breastfeeding and continuing it for as long as possible.

Frequently Asked Questions

1.

How Soon Does Milk Refill After Breastfeeding?

Infants breastfeeding according to their appetite can only empty 70 % of the available breastmilk. Typically, breast milk production functions on a supply-and-demand ground. When the baby breastfeeds, it stimulates milk production. As a result, the mother's body starts making more milk to fulfill the demand. However, milk replenishment after breastfeeding may vary from woman to woman depending on several factors such as hydration, rest, nutrition, and stress levels of the women.

2.

What Foods Should Be Avoided While Breastfeeding?

Breastfeeding women should not eat foods containing artificial additives, preservatives, and trans fatty acids. In addition, the consumption of eating or drinking products with high sugar content, such as large amounts of fruit juice or sweets, is not recommended.

3.

What Decongestant Can Women Take While Breastfeeding?

The American Academy of Pediatrics (AAP) guides that triprolidine and Pseudoephedrine are compatible with breastfeeding. Hence, these two drugs should be the first-line choice.

4.

How Much Milk Does a Baby Gets From Ten Minutes of Breastfeeding?

The amount of milk a baby obtains during a ten-minute breastfeeding session varies depending on several factors, such as the age of the baby, feeding efficiency, and the milk supply of the mother. Some babies may drink a substantial portion of breastmilk during this time, while others may take in only a smaller amount.

5.

How Much Water Should Women Drink While Breastfeeding?

Total fluid intake includes water, hot beverages, milk, and derivatives, soft drinks, and juices; a breastfeeding woman should consume 2480 mL/day till six months postpartum and 2360 mL/day for seven to 24 months postpartum.

6.

What Can Women Put On Their Nipples to Stop Breastfeeding?

A woman may swab a little aloe juice, juice of neem leaves, or bitter gourd juice on nipples to pass off a bitter taste which can make the child repellent breastfeeding.

7.

How to Reduce Engorgement in Breasts When Not Breastfeeding?

To relieve the engorgement in breasts when not breastfeeding, women can try these:
- Apply ice packs or cold compresses to relieve swelling and discomfort.
- Place cold cabbage leaves over the breast.
- Wear a well-fitted supportive bra to get relief and minimize milk production.
- Pain relievers like Ibuprofen can also help relieve pain symptoms

8.

When Does Breastfeeding Get Easier?

Breastfeeding typically becomes easier when both the mother and the baby become more experienced and set a routine which usually happens within the first several weeks after childbirth. As the milk supply of the breasts regulates and the baby becomes better efficient at nursing, the latch (attachment of the baby's mouth to the mother's breasts) gets improved, which ultimately reduces discomfort and increases confidence.

9.

How Much Caffeine Can Women Consume While Breastfeeding?

Maternal caffeine can pass into breast milk. Thus, doctors suggest limiting daily consumption of caffeine to 300 mg/day or less till breastfeeding the baby. In addition, the mother should monitor the baby for irritability or issues in sleeping if they are exposed to caffeine through breast milk.

10.

What Can Women Take To Relieve a Sore Throat While Breastfeeding?

Breastfeeding women can do the following to relieve sore throat,
- Sucking lozenge, sipping honey and lemon, or teas will help reduce symptoms and keep the throat moisturized.
- Anesthetic throat sweets help to relieve throat discomfort.
- Anesthetic throat sprays can anesthetize the throat without causing numbness to the tongue.
- Throat saline rinses.
- Regular steam inhalation with menthol crystal relieves dryness and nasal congestion. 
- Rest and drink more fluids.
- Increasing vitamin C intake.
- Painkillers like Paracetamol or Ibuprofen can help ease pain and fever.
- The doctor may prescribe antibiotics for a sore throat in case of a severe throat infection.

11.

What Allergy Medicine Can Women Take While Breastfeeding?

All antihistamines are regarded safe to use when breastfeeding, as only minimal amounts are excreted into the breast milk, which would not cause any negative effects on a breastfeeding infant. Breastfeeding women can take antiallergics such as Loratadine and Cetirizine.

12.

Can Women Take Cetrizine While Breastfeeding?

When breastfeeding, the use of Cetrizine, which is an antiallergic medication, is considered safe to use for allergies, as they are excreted into breast milk in minimal amounts that are unlikely to have negative effects on the infant.

13.

What to Avoid While Breastfeeding?

While breastfeeding, it is advisable to avoid the following:
- Alcohol.
- Caffeine.
- Tobacco and drugs.
- Certain medication.
- Excessive exposure to environmental toxins.
- Food and drinks containing excessive sugar.
- Foods containing preservatives, trans fatty acids, and artificial additives.

14.

How to Flush Out Dairy From the Body While Breastfeeding?

The women may need to flush out dairy from the body if their baby is exhibiting signs of a milk protein intolerance or dairy allergy.
Women can do the following to flush out dairy from their bodies while breastfeeding:
- Consuming a dairy-free diet by eliminating milk, cheese, yogurt, and butter from the diet.
- Increasing fluid intake to help wash out any remaining dairy products.
- Consuming foods that promote digestion, including fruits, vegetables, and probiotic-rich foods, in diet to support the removal of dairy from the body.

15.

How to Tell if the Baby Is Still Hungry After Breastfeeding?

Below are the signs which may show that the baby is still hungry after breastfeeding,
- Moving fists to the mouth.
- Turning head to look for the breast.
- Opening and closing mouth.
- Sucking on hands.
- Lip-smacking.
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Mohammed Wajid
Mohammed Wajid

Physiotherapy

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