Could Chiropractic Care Help With Breastfeeding? June 21, 2014 13:55
Written By Michelle Roth, BA, LCCE, IBCLC
Imagine your baby’s position in utero – all folded and curled. Now think about the trip your baby makes during birth. In the most favorable situations – when baby’s head is down and anterior, and mom’s pelvis is mobile and open – baby still needs to make several twists and turns to be born. Add to this a modern hospital birth – with induction, lying flat in bed perhaps with your feet in stirrups, immobility due to pain medications, prolonged pushing with pelvic movement restricted, delivery assisted by forceps or vacuum, cesarean birth, and more. It’s no wonder some babies (and their moms!) seem to suffer from physical birth trauma.
Babies are designed for birth – the bony plates of the skull aren’t fused, allowing them to move and overlap in order for the head to move through the maternal pelvis. A baby’s skull is made up of 22 bones with 34 joints or sutures; and, the structures necessary for feeding are controlled by 60 muscles and 6 cranial nerves. 1 While babies are programmed for birth and breastfeeding, if the mechanics of the body aren’t working right, the expected behaviors can be impacted. 2, 3 With so many bones, muscles and nerves involved, the chance for problems is increased, especially when the natural course of labor is impacted by interventions. 1, 3, 4, 5 In addition, even a spontaneous vaginal birth without intervention may cause changes in the infant’s spine, and this misalignment can lead to discomfort and difficulties with all the baby’s systems. 3, 6 The solution? Gentle manipulation and realignment. Treating these misalignments, movement of bones and impingement of nerves – through chiropractic, osteopathy, cranial sacral therapy, etc. – has the potential to improve feeding at the breast. 3 But this type of treatment is not free of controversy.
At the July 2013 International Lactation Consultant Association (ILCA) conference, Dr. Howard Chilton, a neonatal pediatrician, answered an audience question about chiropractic care for infants, saying “this type of management is unproven, has no basis in science and potentially dangerous, both of itself and from the delay in the application of sound medical and nursing procedures …”, going on to call chiropractic care “pseudoscience.” ILCA printed his comments in their newsletter for members, but also printed a response from Dr. Joel Alcantara, from the International Chiropractic Pediatric Association, saying, “Chiropractic is a vitalistic, holistic and patient-centered approach to patient care” and citing research for application in pediatric settings. 7 So what are parents to make of all of this? Can chiropractic care be a beneficial adjunct to allopathic medicine for babies? Could chiropractic therapy help specifically with breastfeeding difficulties?
Two recent literature reviews suggest, while more research needs to be done, the few studies available showed improvement of breastfeeding issues and other problems (such as colic and asthma) with chiropractic intervention for the infant. 8, 9 In addition, Vallone discusses several case studies in which low milk supply was resolved with chiropractic care of the mother. She theorizes that the misaligned vertebrae can disrupt nerve and hormone function, and this can impact breast development (whether before, during or after pregnancy). The type of lactation difficulty will depend on the location of the subluxation; but in the cases she reviews, spinal manipulation showed results (such as, improved milk production and infant weight gain, in addition to maternal comfort) quickly. 10
In a larger case series, Miller and colleagues looked at 114 cases of breastfeeding difficulties where standard care for the infant was supplemented with chiropractic therapy. Infants younger than 12 weeks were referred for chiropractic care after being diagnosed with suboptimal breastfeeding. In this sample, 78% of the babies were exclusively breastfeeding after finishing the course of chiropractic care, which for most babies, was 3 visits. 4
Finally, Holleman, Nee and Knaap write about a case where breastfeeding aversion was resolved with chiropractic care. An 8-day-old baby was seen with the chief complaints being latch problems and a weak suck. Along with these infant issues, the mother suffered from painfully sore nipples. While breastfeeding had gone well for the first 4 days, the baby showed preference for one breast only on day 5, and then began refusing the breast on day 6. After 4 treatments consisting of gentle spinal manipulation and cranium treatments, the baby was nursing normally again. The authors suggest birth trauma may have been to blame (induced labor and shoulder dystocia, in this case). 5
While case studies cannot provide proof that the intervention indeed led to the improvement, what they do show is that this is an area ripe with possibilities for improving breastfeeding and infant health. More study can be done to provide the evidence base for body work in addition to standard care. All of the authors suggest a collaborative approach to breastfeeding difficulties. Pediatricians, family doctors, lactation consultants, chiropractors, massage therapists, etc. should work together with the parents to plan a holistic course of treatment for the infant having feeding difficulties.
- latching difficulties, especially when accompanied by nipple pain or damage
- uncoordinated sucking, or difficulty with suck-swallow-breathe
- preference for only one feeding position or one breast, fussiness in other positions
- needing to nurse “all the time” or cannot transfer milk even though they seem to be nursing
- just as much trouble with the bottle as with the breast
- a fussy, uncomfortable, colicky baby
Openness to new modalities can often be the solution when a mom is about to give up on breastfeeding. Chiropractic care has the potential to alleviate discomfort for baby and mom, and to preserve the nursing relationship.
1Smith LJ & Kroeger M. (2009). Impact of Birthing Practices on Breastfeeding. 2nd ed. Sudbury, MA: Jones & Bartlett.
2 Frymann VM, Carney R, & Springall P. (1992). Effect of osteopathic medical management on neurologic development in children. J Am Osteopath Assoc, 92(6), 729-744.
3 Tow J & Vallone SA. (2009). Development of an integrative relationship in the care of the breastfeeding newborn: Lactation consultant and chiropractor. J Clin Chiropr Pediatr, 10(1), 626-632.
4Miller JE, Miller L, Sulesund AK, & Yevtushenko A. (2009). Contribution of chiropractic therapy to resolving suboptimal breastfeeding: a case series of 114 infants. Journal of manipulative and physiological therapeutics, 32(8), 670-674.
5Holleman AC, Nee J, & Knaap SF. (2011). Chiropractic management of breast-feeding difficulties: a case report. Journal of chiropractic medicine, 10(3), 199-203.
6 Towbin, A. (1969). Latent spinal cord and brain stem injury in newborn infants. Developmental Medicine & Child Neurology, 11(1), 54-68.
7 Lactation Matters. (2013). A Response from the International Chiropractic Pediatric Association.Retrieved from http://lactationmatters.org/2013/11/01/a-response-from-the-international-chiropractic-pediatric-association/
8 Fry, LM. (2014). Chiropractic and breastfeeding dysfunction: A literature review. Journal of Clinical Chiropractic Pediatrics 14(2), 1151-1155.
9 Gleberzon BJ, Arts J, Mei A, & McManus EL. (2012). The use of spinal manipulative therapy for pediatric health conditions: a systematic review of the literature. The Journal of the Canadian Chiropractic Association, 56(2), 128-141.
10Vallone S. (2007). Role of subluxation and chiropractic care in hypolactation. Journal ofClinical Chiropractic Pediatrics, 8(1&2), 518-524.
11 Ohm, J. (2006). Breastfeeding difficulties and chiropractic. Pathways To Family Wellness(11), 24-25.