Feeding your baby is both utterly exhausting and rarely talked about. A majority of breastfeeding women are struggling with some sort of shoulder, back, neck and/or wrist pain so it’s important to correct your posture and positioning early before it becomes a (painful) issue. At Origin, we provide full body physical therapy for women and mothers, so we see a ton of new moms. Here’s our approach to prevent and reduce these all too common breastfeeding aches and pains – do try this at home!
Breastfeeding support starts prenatally. Once baby arrives, it is all too easy and common to focus on their needs and contort your body to get a latch (who among us has not created a new yoga pose while coaxing a baby onto a boob?). During the third trimester we encourage women to work on strengthening their posture, this is done with breathing exercises and by increasing awareness of which muscles are engaged when sitting with a straight back and lowered shoulders. This practiced position then becomes muscle memory for the body to ‘reset’ to when breastfeeding.
The default breastfeeding position can be to slouch forward. The curved spine position with shoulders and head forward, back unsupported and hands positioning the baby's head creates strain on lots of muscles. If a mom has done prehab it is easier to recognize when this is happening and there is some muscle memory that helps them to reset.
Belly breathing helps create an awareness of each muscle. What do those muscles need to be doing to create sustainable breastfeeding posture? Aim for ‘down and back’ – meaning your shoulders should be down (not up by your ears) and you should be sitting against the back of your chair with your back straight, in one long line from your pelvis to your head, chest open, shoulder blades and mid back engaged. Easier said than done, but once you’re here you’ll see that to maintain this posture your baby has to come to you. You might also notice that your feet are dangling, dangling feet means that your lower back has to search for stability and your pelvis and lower back are going to try to support your legs. Enter breastfeeding props: A rolled towel behind the lower back and a footstool are your besties and will ‘remind’ your body to stay in position. A breastfeeding pillow (or pillows, who are we kidding) will bring your baby right up just above your nipple to latch without forcing you to lean forward.
Pregnancy is a whole lot of change spread over 40 weeks, but that postpartum period is the opposite – lots of change all at once. It's easy to focus all your attention on your baby and sometimes that means it takes longer to notice your own comfort, or discomfort. One way to bring awareness back into the body is belly breathing; this is effective because the breath, the pelvic floor, and the core all work so closely together. Belly breathing is breathing ‘into’ your belly, activating your abdomen while relaxing your chest. You can do this by breathing slowly in through your nose and sending it down to your belly and then blowing out slowly through pursed lips.
Take it from Dr. Clampett, PT, DPT, “Breathing is the foundation of everything. We teach belly breathing to all of our patients. If you are breathing with your chest, or shoulders you are not going to be able to recruit your abdomen and the muscles in your mid back, which you need for proper posture and strengthening.”
Breastfeeding rarely goes according to plan so you might find a comfortable hold before, during or after getting into position. Different breastfeeding holds work better for different people, give a few of them a try. Some of our tips to keep top of mind as you experiment:
- Hand and wrist support are key or you could be at risk for the dreaded mommy thumb.This is due to ‘prolonged radial deviation’ aka turning your wrist for an extended period of time, creating strain on the thumb.This is combined with lower estrogen levels during breastfeeding which can decrease the integrity of the tissues especially in hands and feet, causing stiffness.
- Use pillows to bring your baby level with just above the nipple. We like the mantra ‘bring the baby to you, not, bring your boob to the baby.’
- Use rolled up blankets to support your elbow, wrist and hand, it should feel like you are activating your hand to ‘steer’ your baby’s head towards your nipple but not supporting their full weight with your hand. Try to let your props do as much of the work as possible.
- Your baby’s posture matters too, make sure you’re tummy to tummy with them. If they’re turning too far away or in towards you, it’s hard to get a comfortable latch and you might end up overcompensating with your wrist.
But at the end of the day, be gentle on yourself both physically and emotionally.
It's okay, if it's not perfect every time and that doesn't mean you've undone four weeks of physical therapy because there was one challenging feed in the middle of the night where things didn't feel quite right. The ups and downs are normal. And as long as we're trending net up that means that things are going well,
This may seem like a lot to consider so remember it’s not all or nothing. When you have a fussy baby, you're just going to do whatever you need to do to get that latch and to get that feed going. And that's okay, it is never too late to recenter, find where your body needs to be and try again next time. If you need support with any of this – reach out! Our team of physical therapists specialize in supporting moms throughout their entire journey.