The first few weeks with your newborn is a time of joy and celebration, it can also be quite a whirlwind as all family members are finding their new routine and rhythm. During this time challenges are expected to arise, and one particular topic that brings parents and their newborn into a chiropractor’s office, is difficulties nursing. Below, Dr. Kelsey Horsting, D.C., discusses the various biomechanical issues that newborns may face, and how chiropractic care can help bring them back into alignment for successful nursing.

There are powerful health benefits linked with breastfeeding that are well supported by scientific research, which is why parents are motivated to achieve effective breastfeeding. Breast-milk is tailored specifically to the needs of the individual infant and is therefore comprised of a unique combination of nutrients to best support that baby’s well-being. Breastfeeding facilitates bonding between mom and baby and is associated with reduced risk of acute ear infections, severe lower respiratory tract infections, and diabetes among other things.

When it comes to breastfeeding challenges, there is a spectrum in the ways that it can show up in an infant. Inefficient feeding, which is one end of the spectrum of difficulty, may present as excessive spit-up or the need of the infant to constantly be feeding due to the inability to obtain sufficient nutrition to suppress hunger. Dysfunctional feeding may also be experienced as having a preferred side or position for nursing, whereas more severe challenges involve difficulty latching: this includes inability to fully latch, the inability to maintain a latch, and a painful latch for mom. We may also see behaviours that indicate pain in the infant while nursing such as crying, holding their head, and avoidance of feeding which leads to significant concern for the well-being of the infant, and causes a great amount of stress for the parents.

When considered from a biomechanical perspective, successful breastfeeding is an intricate process that requires coordinated motion in the neck, mouth, and jaw. The infant needs to be able to first turn the head, tilt the head back slightly, and open the mouth with the tongue down and out of the way. The jaw then closes, tongue comes up and curves up at the sides, the lips seal around the breast and hold sufficient tension to stand up to suction, and then the tongue ripples from the front to back to express the milk. When we look at it from a step wise process, we can see how complex breastfeeding truly is!

As chiropractors, we can assess the biomechanics of an infant’s neck, as well as the nursing motions: to examine the nursing mechanism the newborn can suck on a pacifier, and we often also use a gloved pinky finger to feel tongue and lip motion, as well as palate positioning. It is important to note that assessing biomechanical dysfunction is one piece of the bigger picture of solving breastfeeding difficulties, which may also involve utilizing a lactation consultant and consulting with a medical doctor or dentist. By way of examining an infant’s neck mobility and nursing mechanism, we are assessing joint alignment, joint movement, muscle activation and global coordination. In other words, we look at the health and function of the nervous, muscular and skeletal systems and how well they interact with each other because we truly cannot assess and treat one system without impacting the others; in that same vein, dysfunction of one system will affect the other systems as well.

For example; if a joint in the neck is not moving sufficiently, there will be less information going to the brain about where that joint is in space, and the brain will create a sub-optimal muscle activation command to move the body, resulting in inefficient movement and muscle tightness which perpetuates the lack of motion in the neck. In the context of an infant, this could impact their ability to turn their head to nurse as well as the ease they feel in this position. In addition, dysfunction of any of the nerves that supply the neck, mouth, and jaw will impact the muscles they supply, subsequently affecting joint movement and the whole feeding process.

To sufficiently assess biomechanical breastfeeding difficulties, a thorough history is taken and then an examination is performed which includes assessment of overall postural alignment and orientation of the infant, their neck and its range of motion, the jaw and tongue motion, palate positioning, as well as muscle tone in all these areas. The history and exam will allow us to determine whether there is a biomechanical issue present and if referral to other professionals is warranted. Treatment is very gentle, using light pressure through the doctor’s fingertips to affect change in the motion, alignment of the joints, and muscle tone. Changes are seen very quickly in infants, typically within a few visits though the number of treatments to reach maximum improvements is dependent on the severity of the condition. As each case is unique, before starting a treatment plan your chiropractor will discuss their recommendations, treatment goals, and answer any questions you may have.

Please note that any advice in this article doesn’t replace personalized medical advice from a professional.

Are you experiencing any challenges related to nursing with your newborn? Both of our chiropractors have 200+ hours of additional training in neonatal and pediatric care and love working with little ones. Email us at info@evolvevancouver.ca to book an appointment with one of our experienced chiropractors.