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What is lactation-informed PT?

Updated: Jan 31, 2022

As a first time mother, I had been given a copy of “Breastfeeding Made Simple”, a book whose title is an extreme misnomer, as most moms I know who have breastfed for any length of time will tell you it’s anything but simple. Despite the somewhat misleading title, it is a wealth of information. I read it while hooked up to the pump, as I had to exclusively pump for several weeks before my preemie could even attempt direct breastfeeding. As I read, I became fascinated. Bolstered by encouragement from my lactation consultant, NICU nurses, and neonatologists to continue pumping and providing breastmilk for the medical benefits for premature babies, my drive to breastfeed was also very much rooted in my interest in the biology behind the entire process. The more I learned, the more fascinated and committed I became. This interest extended to the entire birthing process once I had both witnessed and experienced it, and I couldn't help but feel like I had missed a calling of sorts.

Eventually, via unexpected life changes resulting from the pandemic, I decided to listen to that pull that told me there was some path yet unexplored. But rather than take up a new career entirely, I looked deeper into the role of physical therapy within the space of birthing parents and breastfeeding babies. And clearly IBCLCs and other lactation support specialists own this domain. Feeding therapists such as OTs and SLPs fit nicely into this space. Does physical therapy have a role?

As PTs, we can use our expertise in biomechanics, neuroanatomy, musculoskeletal anatomy, and human development to break down the functional task of breastfeeding into its component parts and intervene as needed with both the parent and the infant. We can examine the role of facial joint and soft tissue mobility in removing milk from the breast, the spinal structural and neurological role in positioning and approach at the breast, and the reflexive movement patterns that are needed to allow the infant these movements. We can examine infant tone and strength, nervous system response, communication and alertness to educate the parent on cues, communication patterns, and co-regulation. We can assess the breastfeeding parent’s anatomy and provide movements and hands-on techniques to influence positioning, mobility, lymphatic movement, and clog/milk drainage. We can intervene when the parent experiences mechanical pain as a result of the repetitive movements and sustained postures of feeding and infant care. We can assess the infant for asymmetry and neuromuscular restrictions that inhibit feeding comfortably and instinctively. We can educate parents about biologically normal development from birth and how to utilize these ingrained, instinctual patterns and movements to make their jobs easier.

As a pelvic-floor trained therapist, I can also provide insight into healing from the trauma of the birthing process, initiate the rehabilitative process, guide return to exercise and work activity, provide hands-on assessment and treatment for impairments, and advise regarding management of physical trauma while caring for the infant and one’s self.

The role of the physical therapist in breastfeeding is wide-ranging when we think about the breadth of our scope and our role in human anatomy, function, and development.

If you’re a fellow PT reading this, what questions come up for you?

If you’re a parent reading this, please get in touch if you think lactation-informed PT is right for you! Use my contact form to send me a message or leave a comment on this post, I would love to hear from you!

For more info on lactation-informed PT, please check out my Instagram posts #lactationinformedpt

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