I have been fortunate enough over the last 15 years to treat women who have had breast feeding problems. Blocked ducts, engorgement, mastitis and positioning for mum’s posture are all areas of Women’s Health that some Physiotherapists can help with.
In Australia we have a post graduate certification in ‘Continence and Women’s health’ however, there is NO module on ‘Breastfeeding’ in this course. There is however a comprehensive 3 day course available in Victoria and Melinda Cooper the Women’s Health Physiotherapist that co -ordinates this course has a directory of practitioners. There are only a couple of us in NSW!!
I love this website – a comprehensive timeline of parenting/feeding
The breast, during breast feeding is extremely adaptable in responding to your baby’s needs. Sometimes, however in the first 4-6 weeks mums may have problems getting feeding established. Lactation consultants and Early childhood nurses are now a lot more available to watch you feeding and help you in those early weeks when breast feeding is often difficult and VERY time consuming. In NSW you can phone your local Early Childhood Health Centre for advice and / or make an appointment to see a nurse specialised in maternal and child health.
In NSW women leave hospital after a normal vaginal delivery NVD within 3-4 days (public-private), and 5-7 days after Caesarean section. Your milk will ‘come in’ usually within 3-4 days following NVD and is often delayed by a day or two after a C section; 5-6 days. Prior to this the breasts will become full or ‘engorged’ and the midwives and specialised nursing staff on your labour ward will help you ‘attach‘ and get the best position for you and baby.
HOWEVER some women go home with engorged breasts, a pump and instructions on how to use the pump to:
1) Help stimulate the milk ejection reflex
2) Rest the sore or cracked nipples. Some home remedies.
3) help with engorgement
Truly there are so many things to get your head around, it’s not surprising that some women encounter problems. You are not alone. If you are not managing your breastfeeding make sure you have a visit organised from your local health centre nurse; lactation consultant as soon as possible after discharge (within 48hours) ; or arrange to stay in hospital longer!!
Engorgement is something that I am seeing a lot more. This can be an extremely painful and debilitating time. The breast suddenly starts to produce milk which must be removed to feed your baby. This is now the sole function of your breasts and a really ‘tense’ full breast may cause difficulty for your baby to latch on.
Blocked ducts respond to early intervention….FEED,FEED and more feeding to help ‘drain’ the affected breast. Carefully guided Lymphatic massage techniques reduce swelling in the breast tissue and so reduce pressure on the delicate milk ducts allowing the baby’s sucking to stimulate the ‘Milk ejection reflex’ This pushes the milk along the ducts to the nipple.
Combined with correct latch and effective tongue action mum and baby can learn to manage any minor blockages.
Therapeutic Ultrasound used by Physiotherapists to treat some acute and chronic inflammatory conditions, if used correctly can be extremely effective in the treatment of Engorgement, blocked ducts and Mastitis. It is vital that you get to see the physio on the same day as the problem…and have a GP appointment booked too! It is sometimes difficult to determine if the problem is a blocked duct or mastitis. The former may respond to early non- medical intervention: the latter will need antibiotics. Your GP will almost certainly be precautious and prescribe antibiotics.
Most mums will only need 2-3 treatments of Therapeutic Ultrasound. This is not painful; and may avoid antibiotics altogether if the block is cleared within 8 hours. Treatment sessions (particularly for engorgement) may take up to an hour and may include you pumping, ultrasound ,massage and feeding . Try and come in with a support person and your baby -especially for the initial appointment.
Teaching mums how to improve their posture and comfort when feeding; gentle lymphatic massage and correct positioning and latch, will help reduce tension and anxiety. This is also a great time for me as your Women’s Health Physio to ask about your birth and do a ‘post-natal’check up and appropriate advice and education on your recovery.
It is so wonderful to see mums quickly gaining confidence as their problem settles and breast feeding becomes easy, enjoyable and precious time spent with baby.
‘truths and myths ‘ A general overview of breast feeding
Mother 2 Mother is a comprehensive American site
La Leche league organization a world wide recognised body for the education of ‘lactation consultants’ and advancement of breast feeding world wide.
The Australian Breastfeeding Association
Ask Lenore -great Canadian website full of great breastfeeding information.
Is this safe when breastfeeding
Listed below are some wonderful Australian websites that offer both information, advice and contact details of all sorts of professionals to help with you during your child bearing year.
Pregnancy Birth and Beyond Jane Palmer is a midwife in private practice located in Sydney, Australia. She has additional qualifications as a childbirth educator and lactation consultant.
Videos on breastfeeding. Most of these have 30 seconds of adds!! Different positions for feeding. You can see videos on attaching immediately after birth on the pre-natal page.
other websites you may find useful :
- This page is a work in progress…more coming soon !