Osteopathy Journals and Research by Darren Chandler

 

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  1. Benefits of breastfeeding for mother and baby

    It is recommended mothers breastfeed for approximately the first six months (26 weeks) (1). After that breast milk alongside other foods will help babies continue to grow and develop healthily.

    The medical reasons for not breastfeeding includes if you have illnesses such as HIV or are taking certain medications that may harm your baby (1). Expectations on new mothers can have negative effects making it difficult to come to terms if they are unable or do not want to breastfeed (2).

    Breastfed babies have (1):

    • Lower likelihood of diarrhoea and vomiting
    • Lower likelihood of chest and ear infections
    • Lower likelihood of constipation
    • Lower likelihood of obesity and later obesity-related illnesses e.g. type 2 diabetes
    • Lower likelihood of eczema

    Breastfeeding doesn’t only benefit the baby but mother too. Breastfeeding is good for mums as it (1):

    • Reduces risk of breast and ovarian cancer (1) 
    • Burns up to 500 calories a day (1)
    • Can help to bond mother and baby (1)
    • Reduces risk of postmenopausal hip fractures (3)
    • Reduces risk of postmenopausal cardiovascular disease (4)

    Exclusively breastfeeding can delay the return of the mother’s periods (1).

    Breastfeeding mothers should look for symptoms such as tiredness, general aches and pains, depression and impaired cognitive function as it could - amongst other causes – possibly, be due to a vitamin D deficiency (5). If experiencing any of these symptoms you should consult with your GP.

    Failing to breastfeed and depression

    There is some link with failing to breastfeed and depression although as a theory it’s not quite conclusive (6). With the pressure some women experience by society and healthcare professionals (2) maybe the depression associated with a failure to breastfeed is hormonal as well as social and self-critical?

    Difficulties to breastfeeding

    Examples of breastfeeding difficulties mothers often report include (1, 13):

    • Mother experiencing pain and/or nipple damage during/after feeding
    • An audible ‘clucking’ sound on feeding
    • Difficulty latching/maintaining an attachment on the breast
    • Baby’s frustration at the breast when trying to feed
    • ‘Gumming/chomping’ on the breast rather than sucking
    • Insufficient weight gain/weight loss of baby
    • Short feeds due to baby tiring
    • Colic/reflux-type symptoms
    • Episodes of sore breasts, blocked ducts or mastitis
    • Thrush around the nipples

    Mechanics of breastfeeding

    In order to breastfeed the baby needs to be able to extend the neck back so when the chin contacts the breast, the baby can search for the nipple (13). In order to allow a deep latch the baby must open their jaw to a wide 120-160 deg angle (7). How the jaw works influences sucking habits (8).

    Impedance of the tongue preventing breastfeeding can be from a tongue-tie. It can make it harder for the baby to attach effectively to the breast. A tongue-tie is when the baby is born with a tight piece of skin between the underside of their tongue and the floor of their mouth. It is easily treated just consult your midwife, health visitor or GP.

    What factors predict breastfeeding patterns?

    Early lactation success is strongly influenced by parity (number of births) but may also be affected by (9):

    (1)  Delivery mode (caesarean (10))

    (2)  Duration of labour

    (3)  Labour medications (such as epidural)

    (4)  Use of non-breast milk fluids and/or pacifiers

    (5)  Maternal obesity

    Obviously the use of any intervention is performed for the medical health of the mother and baby and to prevent complications. Any advice given by your doctor, midwife or health visitor should not be ignored on the grounds of this article.

    Can tension in the neck and jaw prevent breastfeeding? What can be done to help?

    In order for the baby to latch on to the breast the neck has to extend and the jaw has to open to 120-160 deg angle (7). We know the jaw works differently in babies that are breastfed and bottlefed (11). This intern affects sucking habits (8) and bite patterns (12).

    Tension in the jaw and neck are two areas that can be gently released if it is assumed they are inhibiting breastfeeding.

    Some people attribute the mode of delivery as placing strain on the neck (13) which could be a contributing factor. It is generally assumed however the position of the baby prior to birth is more of a reliable predictor of neck strain (14) than the method of birth (15).

    These strains placed upon the baby are possibly the reason why gentle osteopathic manipulative techniques performed by an osteopath, in one paper, helped 70% of mother’s breastfeed(16). It has been suggested in an Australian nursing journal that cranial osteopathy is gaining recognition as a successful treatment for a range of conditions and has shown to be especially useful when dealing with instances of breastfeeding problems resulting from birth trauma(17). It could be in the future the success of breastfeeding may depend on collaboration between the lactation consultant and manual therapist.

    Breastfeeding problems

    http://www.nhs.uk/conditions/pregnancy-and-baby/pages/breastfeeding-problems.aspx#close

    References

    (1)  http://www.nhs.uk/conditions/pregnancy-and-baby/pages/why-breastfeed.aspx#close

    (2) Rachael L Spencer et al (2015). ‘I thought it would keep them all quiet’. Women's experiences of breastfeeding as illusions of compliance: an interpretive phenomenological study

    (3) Bjørnerem A et al (2011). Breastfeeding protects against hip fracture in postmenopausal women: the Tromsø study.

    (4) http://www.unicef.org.uk/BabyFriendly/News-and-Research/Research/Heart-disease/Is-breastfeeding-beneficial-for-maternal-cardiovascular-health/

    (5) Galesanu C, Mocanu V. (2015). Vitamin D deficiency and the clinical consequencies.

    (6) http://www.nhs.uk/news/2014/08August/Pages/Failing-to-breastfeed-linked-with-postnatal-depression.aspx

    (7) Riordan, J., & Wambach, K. (2010). Breastfeeding and Human Lactation.

    (8) Castelo PM et al (2005). Relationship between oral parafunctional/nutritive sucking habits and temporomandibular joint dysfunction in primary dentition.

    (9) Dewey KG et al (2003). Risk factors for suboptimal infant breastfeeding behavior, delayed onset of lactation, and excess neonatal weight loss.

    (10) Sakalidis VS et al (2013). A comparison of early sucking dynamics during breastfeeding after cesarean section and vaginal birth.

    (11) França EC et al (2014). Electromyographic analysis of masseter muscle in newborns during suction in breast, bottle or cup feeding.

    (12) Xiaoxian Chen (2015). Effects of breast-feeding duration, bottle-feeding duration and non-nutritive sucking habits on the occlusal characteristics of primary dentition

    (13) Bertin F (2015). The Osteopathic influence on breastfeeding. Osteopathy Today. Sept/Oct 2015

    (14) Ah Young Jung et al (2015). Factors That Affect the Rehabilitation Duration in Patients With Congenital Muscular Torticollis

    (15) Seung Jae Lee et al (2011). Comparison of Clinical Severity of Congenital Muscular Torticollis Based on the Method of Child Birth

    (16) An independent audit showed that 70% of mothers who sought help with infant feeding found osteopathic treatment helpful. These results are feedback from Feeding Questionnaires received between February 2015 and June 2015 from parents of babies who attended the Chiltern breastfeeding partnership and who had tongue-tie assessment, breastfeeding support and osteopathic treatment.

    (17) Wescott N. (2004). The use of cranial osteopathy in the treatment of infants with breast feeding problems or sucking dysfunction. Aust J of holistic nursing

  2. The 5th to the 11th October is national BackCare Awareness Week, which this year focuses on back pain experienced by children.

    Like adults, children can suffer from back pain as a result of a variety of lifestyle activities.  And like adults, there are a number of things that parents and carers can do to prevent issues arising.

    If your child does complain of back pain, it is important to seek advice from a qualified professional, such as an osteopath.  An osteopath will help to establish the cause of the problem and will provide advice on treatment, or refer you to the appropriate healthcare professional.

    Good school bags

    Children are often required to carry bags full of books, PE kits, musical instruments and other equipment to and from school. Parents should try to limit the weight of school bags as much as possible and invest in a good quality back pack that the child should wear across both shoulders, ideally with a strap across the chest to keep the load close the their body. Packing the bag with the heaviest items (such as laptops and heavy books) closest to child’s body, will also make carrying more comfortable and less likely to strain the muscles of the back.

    Limit screen time

    Looking down to use smart phones, tablets and laptops for an extended period can pull the back and neck into an unnatural posture, resulting in pain. Placing limits on the time spent using devices and encouraging regular breaks may help to avoid problems. If your child has to use a laptop for homework, consider purchasing a support that elevates the screen to a height that allows him or her to sit up straight to look at it.

    Regular exercise

    A sedentary lifestyle is known to contribute to the risk of developing back pain, as well as contributing to obesity. Regular physical activity helps to keep the core muscles that support the spine strong and maintain flexibility, which will help to avoid back pain. Encourage lots of active play, walking, running, swimming, cycling etc to keep your child fit and healthy.

    The right bed and pillow

    Good quality sleep is vital for both physical and mental development. Make sure that your child has a good sized comfortable bed with a firm mattress and a pillow that supports their head without lifting it too high.

    Osteopathic manipulative treatment for your child’s back pain

    Your child’s back pain may benefit from osteopathic manipulative treatment.  Using gentle manual therapy an osteopath will help to resolve any stresses and strains that are affecting their body and relieve their pain. They can also provide lifestyle advice that may help to prevent the problem from coming back.

    Reference: Osteopathy Today. September/October 2015