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What is a Physiotherapists' Role in Infant Feeding and Support?

Introduction

Infant feeding support is a new and growing area of practice for physiotherapists. Although Physiotherapists are helping dyads (moms and babies) with some aspects of feeding for a long time, the systematic assessment and management of breast and bottle feeding are not practiced by many physiotherapists in Canada. Our extensive understanding of infant anatomy, development, and neurophysiology makes us a great asset to those who need help with this functional activity.

With this course, you will learn about the role of physiotherapists in infant feeding support, see clinical practice guidelines for special pediatric populations, hear about new research and upcoming courses, and pose questions to a clinician in this field. 

You Will Learn

  • About the role of physiotherapists in infant feeding support.
  • See clinical practice guidelines for special pediatric populations.
  • Hear about new research and upcoming courses.

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During the early stage of neonates, breastfeeding is very important for the healthy development of infants. At this time milk or milk formulas plays a crucial role in newborn babies. According to the physiotherapist and founder of Vida Health & Wellness in Calgary, Alberta, Mercedes Eustergerling, When we talk about breastfeeding, we usually talk about two people working together. Breastfeeding is a terminology of feeding an infant with your milk from your breast. So, we always consider the conditions that occur from the breast side and the conditions that arise from the infant's side. Before we dive into the topic, there are a few terms that you need to understand. 

  1. Chest feeding: Is used by transgenders, non-binary, or genderqueer individuals, who are identified as males but don't consider themselves to have breasts and are still able to lactate.
  2. Breastfeeding: However, chest feeding and breastfeeding are the same and are a natural phenomenon, breastfeeding is done by females which means feeding an infant with your milk from your breast. 
  3. Breast pumping: Involves, a manual or electric way of expressing milk from the breast using suction devices.
  4. Supplementing Nursing System: Apart from these, you can either use a spoon, cup, bottle, finger feeding or a syringe to feed the baby. These methods of feeding the baby either by milk or by formula through an artificial non-breast medium are called a supplementing nursing system. 

We have practiced finger feeding a baby and cup feeding a baby. We performed a close up of cup feeding on a neonate. Moreover, physiotherapist, Melinda Cooper, offered a course on the lactating breasts in Canada, and according to her

"Those who care for women during pregnancy and childbirth have a crucial role to play in enabling a woman to breastfeed successfully. Now that sound research-based information is readily available to them. Professional ignorance, which may have been acceptable in the past, is no longer tolerable if the potential for helping women to breastfeed their babies is to realize. Professionals must reject much of the received wisdom in this field and pass on-to women only those practices which have been demonstrated to be effective".

Also, Melinda's concern is that a lot of our breastfeeding information and our breastfeeding practices have come down through oral history. Such practices work well when we are talking to somebody as a friend, as an aunt, a sister or close relative but when we are working as a physiotherapist, we have to understand the evidence and have to make sure that we actually deliver evidence-based patient-centered care to those patients just the way we would do it with anybody close to us. Now, Melinda only works with the adult population. She doesn't work with the babies anymore. So if we are going to help these babies with their motor function, then it is important to understand the mechanics of feeding the breast and bottle and some of the other devices and we should help to optimize that function.

The Physiotherapists Role

Specific to the breast, one of the things that the physiotherapists can help is - inflammation, which can happen in the lactating breast. The common cardinal signs of breast inflammation cancer include redness, heat, pain, swelling, and loss of function. The actual work of the physiotherapist is to restore the optimal functionalities of these body parts. If a function is impaired by inflammation of tissues, we can address it when we already do this. In other conditions, we do it in ankle sprains, we do it for inflammatory arthritis, we do it for complex regional pain syndrome and a variety of other conditions, that involve inflammation.

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Ways Of Helping In Breastfeeding

Another way that we can contribute to helping with breastfeeding is with Skin integrity. Breastfeeding can cause nipple and skin damage, and physiotherapists, in general, are trained to repair skin integrity. During breastfeeding nipple pain is common as there are excessive pressure and compressive forces that repeatedly pertain to the same tissues, like bedsores, fitting sports equipment like helmets and shoes, wheelchair design, and our population with diabetes, we help them to optimize their skin integrity.  

A Physiotherapists' Role In Pain

It is recommended that physiotherapist should be very familiar with pain, in the profession. There is a heated argument made by some physios to be pain specialists and for that to be what we focus on. According to Mercedes, what we bring to the table is a recognition that there's a whole human being in front of us and we can take a holistic (Biopsychosocial Model) approach. Generally, a biopsychosocial approach covers all the aspects of the pain experience, for example, pelvic health, bladder pain syndrome, prostatitis, people with lupus, rheumatology and MSK background, TMJ disorder, migraine, and SLE. Physiotherapists are already playing an important role in pain assessment and management and this can contribute a lot because breastfeeding sometimes is painful. 

Conclusion

Lastly, physiotherapists want to challenge their profession to recognize that the breasts are part of the woman and are made to lactate. They might be doing people a disservice if they say that we will treat all of your body parts except this one body part. Concluding, physiotherapists need to look at the body as a whole and its main function is to produce milk. Also, they should start asking people about breastfeeding goals, what are the barriers that resist them from this functional activity and later they can analyze what they can do within our scope of practice.

Definitions: 

MSK: Musculoskeletal disorder, is a term associated with conditions affecting the muscles, joints, and skeleton. 

TMJ Disorder: Temporomandibular joint disorder affects your jaw joints, causes pain in the joints and muscles by affecting the jaw movement.

Rheumatology:  It is a branch of medicine that focuses on the study of rheumatic disease and other disorders related to your joints, ligaments, and muscles.

SLE: Systemic Lupus Erythematosus, is a disease related to the immune system, where the body's immune systems attack the healthy tissues mistakenly.

Biopsychosocial Model: The biopsychosocial model is a collaborative version that generates interconnection between biology, psychology, and socio-environmental elements.

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This course is brought to you by the Canadian Physiotherapy Association and taught by Mercedes Eustergerling.

About The Instructor

Mercedes Eustergerling BKin, PT, Lactation Consultant

Mercedes is a women’s health physiotherapist and the founder of Vida Health & Wellness in Calgary, Alberta. She received a Bachelor of Kinesiology from the University of Calgary in 2008, a Master's of Physical Therapy from the University of Western Ontario in 2010, a Post-Graduate certificate in pain management from the University of Alberta in 2014, and a Master of Health Management from McMaster University in 2018.

Mercedes has unique experience in physiotherapy for breastfeeding support and is an international board-certified lactation consultant (IBCLC). She is passionate about bringing a physiotherapy approach to the lactation world and bringing lactation into the physiotherapy practice. Mercedes researches on breastfeeding and lactation-related conditions, and she teaches courses on infant feeding for health professionals across North America.

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