Avoiding Repetitive Stress Injuries while Breastfeeding

As a chiropractor who works with a lot of new moms, I often see women presenting with various injuries that appear to be related to positioning while breastfeeding. Babies nurse frequently in the early months, and if a mother is not in a comfortable position, repetitive stress can sometimes result in wrist, thumb, elbow and neck injuries. Breastfeeding is, of course, the natural way for mothers to feed their babies, so as I saw these injuries, I figured that there must be a way for women to reduce if not completely eliminate the chances of repetitive stress injury resulting from positioning while breastfeeding.

After consulting with some experts in the Ottawa area, I discovered a fantastic alternative to the more traditional breastfeeding postures such as the football and cradle holds. Laid back breastfeeding (also called baby-led breastfeeding) involves a mother leaning back into a semi-reclined position, with all body parts supported; baby's position is face down on mom. The baby is supported by mom as he follows a series of instinctive behaviours to get to the breast.

Using the principles described above, breastfeeding can be a lot more comfortable! If a woman lies back with her neck supported and her baby lying on top of her, her neck and shoulders are free of strain and her arms do a lot less work.

Babies are well equipped from birth to find the breast, and the close contact between mom and baby with a laid back position encourages a baby's instinctive breast seeking behaviours. A sitting up position tends to create a lot more challenges in terms of wear and tear on a mother's body, as her baby's weight is partially or completely supported by her arms.

Susan Martensen, an Ottawa birth and postpartum doula, believes that laid back breastfeeding has many benefits for mothers. "It is easier for mom as a preferred position," says Martensen. "Imagine a woman who has given birth, she is experiencing tenderness in the perineal area following a vaginal birth, or in the lower abdominal area if she has had a caesarean birth. The benefits are that she takes pressure off these areas, thereby maximizing her comfort."

Although these principles may seem fairly intuitive, you will want to consult with a professional if you are finding breastfeeding challenging. Fleur Bickford, a local International Board Certified Lactation Consultant and Registered Nurse, acknowledges that a lot of women experiment with different techniques as they figure out what is best for them and their baby. There is not one position that is best for all mothers and babies. "Some moms find the laid back position a difficult one initially because it is usually not something they have seen before," says Bickford. "If this is the case, mom can latch baby on in a more upright position and then lay back. It is also important for mothers to understand that although it is often called 'baby-led' breastfeeding, that doesn't mean that mom shouldn't help. Breastfeeding is a relationship, and mom should follow her instincts and support her baby as she feels necessary."

Bickford also comments that the laid back posture can aid in resolving nursing issues. "It can be a very useful position for babies who have issues with latching or sucking."

Here are some of the other benefits for your baby with laid back and baby-led breastfeeding:

Belly to Belly: The positioning of baby on his stomach helps stabilize the baby, while helping him feel secure and triggering certain newborn reflexes that can help with breastfeeding.

Hands Free: The baby is not restricted by arms or positioning as she would with the mother in an upright position, and this can assist with the instinctive aspect of latching.

Natural Attraction: Gravity helps to keep him close to his mother and keep him on the breast and latched

Basic Instinct: Babies find the breast by feel, not sight so these principles allow your baby to be in contact with the breast much more than other more common positioning, and they also allow him to feel his way to the breast.

This method many not be the right fit for every mother. "If you are breastfeeding and find that the laid back positioning does not work well for you," says Bickford, "you can help yourself to avoid repetitive stress injuries by paying attention to your position while nursing, and making sure that you are well supported. Many new mothers make the mistake of leaning over their baby and trying to take the breast to baby. Try to be conscious of first sitting back and making yourself comfortable, and then bringing your baby to your breast. Once your baby is latched on, you can use pillows or folded blankets or towels to support your arms and hands so that you are not supporting the whole weight of your baby."

Martensen has had much success recommending these principles to her clients, she says "I offer laid back breastfeeding to all of my clients and approximately 90% try it successfully. This concept is natural and simple, inspiring confidence in the mother and not requiring complex instructions. The mothers and babies do very well. By being skin-to-skin, they both thrive, the babies' weight loss is minimal and they regain and surpass their birth weight usually within the first week."