As a Breastfeeding Therapist (or OT specializing in breastfeeding) I view both mother and baby as dynamic, separate beings to evaluate, consider, and treat, as well as, an inextricably linked, symbiotic, interdependent pair, where the evaluation of one, cannot be fully considered without evaluation of the other. The wellbeing and functioning of one, cannot be optimized without optimal wellbeing and functioning of the other. (If baby is not doing well, then mother isn't doing well. If mother isn't doing well, then baby isn't doing well.)
Goals of treatment are determined by the breastfeeding family (with guidance from the Breastfeeding Therapist as desired) and change and evolve as needed. Breastfeeding looks different for different families and can include breastfeeding at the breast, providing breastmilk with an alternative feeding method, exclusively pumping, combination feeding, providing donor milk or formula with an at-breast supplementer, etc. There is no one right way to breastfeed.
Breastfeeding Therapy can include a variety of adaptive equipment and tools, such as at-breast supplementers, finger feeders, nipple shields, bottles (used therapeutically), breast pumps, baby scales, ultrasound, etc.
Breastfeeding Therapy considers many aspects of the mother-baby dyad in order to evaluate them as holistically as possible. Some factors to consider include, but are not limited to:
1) personal aspects of both mother and baby (positioning and latch; SSB coordination; baby's weight gain and development; milk transfer; mother's breast anatomy and baby's oral anatomy and their functioning-- independently and together; mother's posture; baby's development and milestone achievement, neuromotor functioning, reflexes, tone, sensory processing/organization, body alignment, symmetry, and movement patterns; mother and baby's mental health; etc.)
2) the physical and social environment in which mother and baby live (such as family and community support and the ergonomics of mom's favorite breastfeeding chair).
As a Breastfeeding Therapist, I utilize many modalities to achieve a holistic, integrative treatment of the mother-baby dyad. In addition to positioning and latching assistance, treatment for baby could include:
oral motor therapy, bodywork that is painless and neuroprotective, movement and play to promote neural connections and proper development and milestone achievement, positioning to decrease plagiocephaly, sensory integration to promote calming, and play to facilitate caregiver and baby bonding.
For mother, treatment could include:
strategies to regulate/improve supply, ergonomic positioning to ease musculoskeletal pain and fatigue, the healing of sore nipples, therapeutic ultrasound to address clogged ducts, and mental health support strategies such as motivational coaching, stress management and sleep hygiene, task simplification to facilitate an easier daily routine, and identifying sources of additional support such as family, friends, postpartum doulas and community mother support groups.
Finally, as a Breastfeeding Therapist, while I strive to holistically treat breastfeeding challenges as efficiently and comprehensively as possible, when needed, I also make referrals to additional services when I assess that a breastfeeding family could truly benefit.
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So to summarize:
Breastfeeding Therapy is the therapeutic treatment of the breastfeeding dyad. Mother and baby are evaluated and treated as both separate beings and as an inextricably linked, symbiotic, interdependent pair. The wellbeing and functioning of one, cannot be optimized without optimal functioning and wellbeing of the other. Goals of treatment are family determined and dynamic and are guided by an evaluation of functioning that considers personal aspects and environment of mother and baby. The Breastfeeding Therapist utilizes a variety of adaptive equipment, tools, and modalities to holistically treat the breastfeeding family, optimizing function, and ultimately breastfeeding, of the mother-baby pair.
*** I've written this post to try and help explain what I mean when I refer to my work as Breastfeeding Therapy. I confess that the explanation evolves as my practice evolves, and thus this definition will evolve too! But for now, I hope it is a helpful explanation!