1. Breastfeeding is important for both baby and mother's health, but global rates remain low due to various barriers. Physiotherapists can help by ensuring proper positioning and latch during feeding. 2. Assessing the latch, infant oral structures, and correcting improper posture are important to prevent problems and maintain comfort. Oromotor stimulation also aids preterm infants' feeding skills. 3. Clogged ducts and mastitis can result from issues like poor latch, but physiotherapists treat them through techniques like massage, ultrasound, and k-taping to relieve pain and encourage milk flow.

1. PHYSIOTHERAPY IN LACTATION &
BREASTFEEDING
-S.RISHWANA FATHIMA

2. WHO(WORLD HEALTH ORGANIZATION)-
BREASTFEEDING A MAJOR CONSIDERATION
•Globally,3 in 5 not breastfed in the first hour of life.
•Over 820000 could be saved yearly if all children 0-23 months were
optimally breastfed
•Only 41% of infants under 6 month of age are exclusively breastfed
•In India, only 46.4% infants under 6 months of age are exclusively
breastfed.

3. IMPORTANCE OF BREASTFEEDING
BENEFITS FOR THE BABY
• Promotes healthy weight gain
•Perfect nutrition that customized everyday based
on nutritional demand.
•Protection from respiratory infections, diarrhoeal
disease.
•Boosts brain development.
•In long term,breastfeeding increases the IQ
among children.
•Protection against obesity & non-communicable
diseases.
BENEFITS FOR THE MOTHER
•Reduces the risk of malignant ovarian
tumor,malignant tumors of breast
•Prevents development of mastitis
•Prevents postpartum haemorrhage
•Lowers risk of type-2 diabetes
•Prevents osteoporosis
•Prevents cardiovascular disease
•Helps spacesubsequent pregnancies.

4. LACTATION & BREASTFEEDING
•Breastfeeding is one of the most effective ways to ensure child health
and survival.
•WHO(world health organization)has made breastfeeding as major
consideration to reduce the infant mortality and to improve the
breastfeeding rates globally which is minimally processed due to the lack
of proper awareness about breastfeeding in mothers and her family true
informed decision making and other reasons such as improper mother
and infant positioning and attachment during breastfeeding.

5. HOW DOES PHYSIOTHERAPIST HELPS IN
BREASTFEEDING?
•POSITIONING- Breastfeeding mother position and baby position is very important for effective milk
withdrawal of milk
•ASSESING THE LATCH-Proper latch is a deeper latch and assessing the latch is very important for effective
withdrawal of milk
•CORRECTING THE IMPROPER POSTURE-Breastfeeding mothers are supposed to feed the babies every 2
hours and meanwhile in demand.So,posture corrctions should be done to prevent the neck and back strains.
•INFANT ORAL EXAMINATION-Oral examination done to identify any type of lingual frenulum(tongue tie)
which impacts breastfeeding
•OROMOTOR STIMULATION-Preterm babies have difficulty in coordinating suckling,swallowing and breathing.
oromotor stimulations plays a immense role in suckling ad swallowing
•CLOGGED DUCTS AND MASTITIS-Proper postioning and modalities such as ultrasound is used to relieve the
pain.k-taping and manual lymphatic drainage(MDL) results in significant reduction in pain and breast
engorgement.

6. 1.POSITIONING
Breastfeeding positions ensures mother a comfortable posture and also a good
latch for the baby.
COMMON BREASTFEEDING POSITIONS
1.CRADLE HOLD
•Easy and common hold that is comfortable for most mothers and babies
•Mother should hold the baby’s head with forearm and whole body facing towards mother
2.CROSS-CRADLE HOLD
•This hold differs from cradle.If mother is feeding from right breast,she should use the left hand
arm to hold the baby and turn the baby chest,tummy are directly facing mother.
3.FOOTBALL HOLD
•Mother should position the baby at side with pillows.She should hold baby head with one hand
and should hold nursing breast with other hand.

7. COMMON BREASTFEEDING POSITION

8. 2.ASSESSING THE LATCH
A baby and mother should be in proper position for the deeper and
effective latch
•“DEEP LATCH” is the key for effective breastfeeding
•The better the latch is the more easily baby removes milk from the ducts.
•For deeper latch:
Baby mouth angle should be in 140 degrees
Baby neck should be extended and forehead should be away from the breast
Lower areola should be within infant mouth
Chin close to breast
Baby mouth should be wide open

9. DEEP LATCH VS SHALLOW LATCH
Adressing and ensuring a proper latch early on will help to prevent
problems down the line to the breastfeeding journey.

10. 3.CORRECTING THE IMPROPER POSTURE
Proper posture during breastfeeding is very important to prevent the strains that
occur in neck,shoulders and back region
•Optimal breastfeeding position should be maintained along with proper back support to prevent
spasm.
•Periodically stretching and exercising helps mothers to overcome the muscle tension and to
relieve neck and back pain
POSTURAL ADVICE:
Mother should always bring the baby towards her and should avoid slouching down to the baby
Mother shoulder must be back and supported
Mother should have her arms supported by pillows this can avoid loading to neck and
shoulders

11. SHOULDER STRETCHES
Pectoral stretches in 3 directions in the doorway at 120
degrees,90 degrees and 60 degrees

12. NECK STRETCHES
Upper trapezius and levator scapulae streches

13. UPPER BACK STRETCH
Arching back over the chair in sitting

14. 4.INFANT ORAL EXAMINATION
ASSESING THE ORAL FRENULUM IS VERY IMPORTANT WHICH CAN LEAD
TO IMPROPER LATCH AND INEFFICIENT MILK WITHDRAWAL
ASSESING THE FRENULUM(TONGUE TIE):
Elevate and push tongue back
Gently push the tongue backwards
Gently mobilize the tongue front,back,up
and down.
See through any thin tissue that attaches
to the posterior tongue

15. 5.OROMOTOR STIMULATION
INFANT OROMOTOR STIMULATION AIDS IN COORDINATED
SUCKLING,SWALLOWING AND BREATHING
•Oromotor stimulation (OMS) is the manipulative actions of the lips, jaw, tongue, soft palate
before feeding with or without Nutritive sucking (NS) or non- nutritive sucking (NNS) events,
intended to improve preterm infants sucking and feeding.
•Oral stimulation improves the oro-motor skills and growth velocity in 28-32 week preterm
infants
•Teaching mothers to administer oral motor stimulation for their infants improves feeding
behavior

16. 6.CLOGGED DUCTS & MASTITIS
Pelvic Health Physical Therapists are in a unique role to help women achieve success
with breastfeeding by treating blocked milk ducts with a skill set as physical therapist
WHAT ARE CLOGGED DUCTS?
•When milk is not effectively removed from the breast, milk stasis occurs leading to a blocked or
“clogged” duct
•This is characterized by a tender lump in the breast, erythema, or even hard, painful swelling
that includes a significant portion of the breast
•A bleb, or a small white bump on the nipple, may form also creating a further reduction or
cessation of milk flow
•It is estimated that 2/3 of breastfeeding women experience blocked milk ducts

17. RISK FACTORS OF CLOGGED DUCTS
•Improper baby latch or positioning
•Ineffective suckling
•Sore or damaged nipples
•Breast engorgement
•Finger compression of the areola with breast feeding
•Pressure from a tight-fitting bra or shirt
•Milk overproduction
•Infrequent or missed feeds
•Changes in feeding schedule

18. PHYSIOTHERAPUETIC INTERVENTIONS
FOR CLOGGED DUCTS & MASTITIS
•‘Effective deep latch’ with switching breasts more frequently and nursing,massaging the breast
while feeding or pumping, applying and hot compress/towel on the breast before feeding are
first and foremost remedies for clogged ducts.
•Postural re-eduation/ergonomic positioning for optimal breastfeeding positions
•Modalities such as therapeutic ultrasound. Research has shown that applying heat through
soundwaves can help bring blood flow to the area and reduce inflammation to help unclog the
duct (Markowski, 2019)
•K-Tapping aids in lymphatic drainage ,swelling and inflammation.

19. THANK YOU