Breastfeeding Difficulties

What to Expect When You Take Your Baby to a Chiropractor

You have a newborn baby. Congratulations! Like so many other new parents, you’re probably also struggling with breastfeeding and at your wit’s end trying to find help. You’re exhausted, maybe even depressed, and willing to try anything. You probably sought help from a Lactation Consultant who may or may not have suggested that you see a Pediatric Chiropractor. You may have done your own research or asked around and heard that we can help. Whichever way you found yourself in the office of a Pediatric Chiropractor…Congratulations again! You’ve likely found a big piece of the puzzle and are on your way to resolution.

In my office, I begin each new patient visit with a detailed consultation where we will talk about the challenges you and your baby are experiencing. I will gather a full history of your pregnancy, delivery, and all of the factors that might have caused trauma or imbalance to your baby.

We’ll discuss how your baby is feeding and address factors such as the latch, the duration and frequency of feeding, and the overall ability of your baby to nurse effectively. We’ll also discuss your baby’s overall state of being—is she fussy, colicky, gassy, unsettled, or just very tight and tense in her body? This will be a time for you to tell me everything.

The next step is for me to look at your baby—to do a visual examination. Your baby will be laid on a large pillow. Initially, I like to just stand back for a moment without touching her and see what she does all by herself. Does her whole body curve to one side? Does she tilt or rotate her head to one side? How does her head look? Are there any areas that bulge out or sink inward? Are her facial features symmetrical? Are her eyes even? Is one more narrow or appear to be lower than the other one? Does one jaw or one cheek appear to be lower than the other one? Is her chin in the midline? All of these features are determined by the alignment of the spinal and cranial bones underneath them.

Sometimes it is very apparent that there is a structural imbalance just by looking at these details. If your baby wants to breastfeed during our visit, I might even assess the baby’s latch at your breast; looking to see if she can open her mouth widely over your nipple and areola or if she is just sucking shallowly on the nipple alone.

Once I’ve assessed your baby’s alignment visually, I’ll very gently start to palpate and feel her body—her sacrum (in her pelvic region), her upper neck, the sides of the skull, her jaw, and various other cranial bones. I might even feel the roof of her mouth (the palate) to determine if it is overly high or not and feel the strength of her suction of her tongue at the same time. The pressure used during this exam is very slight. Often, I hear that it doesn’t look like I’m doing anything at all! I will be feeling for muscle tension, alignment, and comparing the motion from one side to the other. All of this will help me to determine the restrictions and imbalances in your baby’s body.

The pressure used during the adjustment is very slight and is done by light pressure point work and massage. There are absolutely no forceful “cracking” type movements that are often associated with a chiropractic adjustment for an adult. This is very different.

So…the big question to address here is why? What do these restrictions and imbalances have to do with your baby’s ability to breastfeed?

The main fact is that when breastfeeding challenges occur, sometimes the problem is not with the mother’s technique, but rather with the baby himself—barriers within the alignment and tone of his body causing abnormal function and preventing normal breastfeeding.

For example: Your baby must be able to open his or her mouth wide enough to get much of your areola into the mouth. This is referred to as the latch. The milk ducts are deep within this breast tissue. If the baby has a shallow latch (and is not able to open the mouth widely), he will be clamping down on your nipple. This not only hurts and can cause damage to your nipple, it also doesn’t access the deep milk ducts; making milk transfer much harder. He must work much harder than he should to feed and might tire easily, fall asleep at the breast, and/or feed too often in order to feel full.

This is usually due to the misalignment of the jaw. The TMJ or temporomandibular joint (the jaw) is the union of the Temporal bone, which sits just lateral to the upper neck, and the Mandible. Your baby’s cranium and spine are not fused and are very pliable. Issues of abnormal in-utero positioning and the birth process can cause these bones to shift out of normal alignment.

Your baby must also have the have the normal use of his tongue. Your baby must be able to squeeze your breast tissue tightly to the roof of his mouth in order to create a vacuum seal and suction pressure to transfer milk. If your baby does not have normal use of his tongue, then he likely can’t drain the breast completely. All of the muscles that form the tongue and allow for all of it’s ranges of motion are attached to various cranial and spinal bones—mostly to the Temporals, the Mandible, and the Hyoid bone in the upper neck. Once again, if these underlying structures are imbalanced, then these muscles will be pulled and strained. This causes the tongue to be tethered (not able to move normally) and weak.

As more research shows favorable results and more babies can breastfeed more successfully after chiropractic care, I am happy to see that the chiropractor is being included in the breastfeeding care team more and more often.

Now getting back to your chiropractic visit. After the consultation and examination, I will adjust your baby. Just like the palpation portion of the exam, the pressure used during the adjustment is very slight and is done by light pressure point work and massage. There are absolutely no forceful “cracking” type movements that are often associated with a chiropractic adjustment for an adult. This is VERY different.

I recently came across an amazing, very long and thorough study that compares the safety and the forces used by different types of therapists caring for the breastfeeding dyad. You might be surprised with the findings. When comparing these difference approaches for their safety and force used during the treatment, it says:

“Many manual techniques used by chiropractors are similar to the manual therapies used by other providers. This includes osteopathic craniosacral therapy, which has been measured at a force of 1 N (0.2248 lb./second) and spinal manipulation/mobilization performed by physical therapists, measured at a force of 22 N (approx. 5 lbs./second) in adults. Medical manual therapists have been found to apply manual therapy to children using forces of 50 to 70 N (11-16 las./second).”

This is telling us that the chiropractic adjustment and cranial/sacral therapy is by far the gentlest of all the other approaches—physical therapy and “manual” therapy (including massage). The authors go on to test how effective the adjustment and cranial therapy was for 179 infants in the study. They say:

“In all the case reports and most of the case series, the patients’ suckling ability was observed to improve.”

As more research shows favorable results and more babies can breastfeed more successfully after chiropractic care, I am happy to see that the chiropractor is being included in the breastfeeding care team more and more often. I hope this article serves to increase your confidence in our care and gentleness.

It is very important to make sure that the chiropractor you choose for your baby has been specifically trained in pediatric cranial work. Not all chiropractors are alike. Just like medical doctors, there are many different specialties within our profession. You wouldn’t take your baby to a podiatrist to treat an ear infection. You would be very disappointed in the care, there likely would not be a positive resolution, and then you might tell all your friends that the treatment didn’t work. In the same way, please seek a qualified specialist for help with breastfeeding.

One of my favorite quotes about this “best practice” model of care says:

“As the lactation consultant and chiropractor find a common language in their abilities to assess form, function, competency and compensations, the dialogue between them can expand and the opportunity to provide broader and deeper healing is a realistic and achievable objective…

The very possibility of restoring the competency that forms the foundation for all loving human relationships is surely a worthwhile goal by all accounts.”