Is Baby-Friendly Breastfeeding Mother-Friendly?

The influence of breastfeeding factors on the prevalence of back and neck pain: data from an online survey

BACKGROUND

Sometimes during breastfeeding women adopt positions that may cause problems with musculoskeletal system, resulting in back pain. The aim of this study was to determine the prevalence of lower back, upper back and neck pain in breastfeeding women and how this may be related to the act of breastfeeding.

METHODS

An online survey within Poland was conducted among 395 breastfeeding women who were 1 to 48 months postpartum and were divided into two groups; "no back pain" and "back pain present". The measurement tools used included an original questionnaire, the International Physical Activity Questionnaire (IPAQ), a Numerical Pain Rating Scale (0-10), and the Roland-Morris Disability Questionnaire. Pearson's chi-squared tests, Mann-Whitney U tests, Student's t-tests, and Kruskal-Wallis ANOVA tests were used to compare the groups.

RESULTS

It was found that 84% of breastfeeding mothers suffered from back pain at least once a month. Pain was experienced at least once a week in the cervical, thoracic and lumbosacral regions in 48%, 36%, and 66% of the women, respectively. A dysfunctional state was present in 27.6% of breastfeeding mothers who suffered from back pain. Mothers experiencing back pain spent significantly more time on single breastfeeding episodes (p < 0.05) and had an increased total time breastfeeding per day (p < 0.01) compared to mothers with no back pain. Neck pain was significantly less intense in mothers preferring to breastfeed in a lying position as compared to mothers preferring a sitting position in a chair or an armchair (p < 0.05).

CONCLUSIONS

This survey of Polish breastfeeding mothers revealed a very high prevalence of lower back, upper back and neck pain. The amount of time spent on breastfeeding and the choice of body position for breastfeeding were important factors differentiating the prevalence and intensity of the pain. It is recommended that breastfeeding mothers do not extend the single-feeding time in the adopted position beyond the required time. It is of utmost importance to choose a breastfeeding position in which all parts of the mother's body are supported. To prevent neck pain, lying and semi-lying positions with head support are recommended.

Breastfeeding-related neck pain: prevalence and correlates among Nigerian lactating mothers

BACKGROUND

Breastfeeding (BF) is a physically demanding task and is predominantly performed in a head-down position as the mother attempts to maintain eye contact with the infant. There are possibilities of BF-related neck pain (BFRNP) that have not been widely studied. This study investigated the prevalence and correlates of BFRNP in Nigerian lactating mothers.

METHODS

A cross-sectional descriptive survey was conducted among 310 lactating mothers selected from post-natal clinics in Enugu, Nigeria. Information on their BF profile was sought as well as the prevalence and characteristics of BFRNP using a self-structured questionnaire.

RESULTS

It was found that cradle hold was the commonly adopted BF position (94.0%) and the majority breastfed ≥10 times daily (55.2%) for <30 min per session (49.1%). BFRNP was seen in 51.7% of women, of which 55.0% reported moderate pain intensity and 60.0% experienced this pain during BF. None of the maternal characteristics and breastfeeding profiles were significantly associated with the prevalence of BFRNP (p>0.05).

CONCLUSIONS

There is a high prevalence of BFRNP among nursing mothers. Although maternal characteristics and BF positions were not associated with reported BFRNP, the results suggest that changing BF positions reduces neck pain during nursing sessions. Therefore this study recommends that nursing mothers should regularly change their BF positions to increase relaxation and comfort.

Neck Muscles' Responses to Cradle, Cross-cradle and Football Breastfeeding Hold Positions in Nursing Mothers: A Preliminary Study

Background

Breastfeeding-related Neck Pain (BFNP) is prevalent in nursing mothers and cuts across the utilization of different breastfeeding (BF) hold positions. Biomechanical considerations to highlight ergonomically safe BF positions for the prevention of BFNP have not been previously studied.

Aim

This study was designed to compare the electrical activities of selected neck muscles across three breastfeeding hold positions [cradle (C1), cross-cradle (C2), and football (FB)].

Materials and Method

Surface electromyographic analyses of four neck muscles (right and left components of each trapezius and sternocleidomastoid) were performed respectively during three BF trials with different BF hold positions (C1, C2, and FB) in 22 nursing mothers. For all the trials, the mothers nursed from the left breast.

Results

Across the three BF trials, the electrical activities of each of the neck muscles did not vary significantly (P > 0.05). Furthermore, the left muscular components showed predominantly higher activities, as compared to their right components.

Conclusion

The breastfeeding hold position adopted during BF tasks may not be a determinant of BFNP in nursing mothers. Further studies to ascertain the biomechanical implications of the utilized BF holds are recommended.

Evaluation of trunk muscle activities in response to three breastfeeding positions utilised by women

BACKGROUND

High prevalence of breastfeeding (BF)-related musculoskeletal disorders (MSDs) in nursing mothers have been reported in previous studies. Studies are scarce on the biomechanical effects of the commonly utilized BF positions.

OBJECTIVE

This study evaluated the electromyographic (EMG) activities of the trunk muscles in response to three BF positions commonly utilized by mothers globally.

METHODS

20 non-pregnant nulliparous females participated in this experimental study. EMG activities from erector spinae (ES) and external oblique (EO) muscles were recorded bilaterally in three BF conditions: cradle (C1); cross-cradle (C2); football (FB). Data were analyzed using descriptive statistics and inferential statistics of one-way analysis of variance with alpha level set at 0.05.

RESULTS

The activity levels of right EO and ES muscles significantly increased during the C2 hold, while the left EO and ES muscles revealed significantly higher EMG levels in the C1 trial. Asymmetrical activity between the right and the left parts of the EO muscle was significantly higher during the C2 hold.

CONCLUSION

These findings suggest that compared to C2 and C1 holds, FB hold may be more biomechanically efficient relative to its decreased muscular demands. The physical stresses associated with BF may be higher with the adoption of C2 and C1 holds, especially for prolonged periods.

Knowledge, attitude and techniques of breastfeeding among Nigerian mothers from a semi-urban community

BACKGROUND

Mothers' poor knowledge and negative attitude towards breastfeeding may influence practices and constitute barriers to optimizing the benefits of the baby-friendly initiative. This study assessed breastfeeding knowledge, attitude and techniques of postures, positioning, hold practice and latch-on among Nigerian mothers from a Semi-Urban community.

METHODS

Three hundred and eighty three consenting lactating mothers who have breastfed for 6 months and up to two years volunteered for this cross-sectional survey, yielding a response rate of 95.7%. A self-administered questionnaire that sought information on maternal socio-demographic variables, knowledge, attitudes and breastfeeding techniques of mothers was employed.

RESULTS

Based on cumulative breastfeeding knowledge and attitude scores, 71.3% of the respondents had good knowledge while 54.0% had positive attitude. Seventy one point three percent practiced advisable breastfeeding posture. Sitting on a chair to breastfeed was common (62.4%); and comfort of mother/baby (60.8%) and convenience (29.5%) were the main reasons for adopting breastfeeding positions. Cross-cradle hold (80.4%), football hold technique (13.3%), breast-to-baby (18.0%) and baby-to-breast latch-on (41.3%) were the common breastfeeding techniques. A majority of the respondents (75.7%) agreed that neck flexion, slight back flexion, arm support with pillow and foot rest was essential during breastfeeding. There was no significant association between breastfeeding posture practice and each of cumulative breastfeeding knowledge score levels (X2 = 0.044; p = 0.834) and attitude score levels (X2 = 0.700; p = 0.403).

CONCLUSION

Nigerian mothers demonstrated good knowledge and positive attitude towards breastfeeding. Most of the mothers practiced advisable breastfeeding postures, preferred sitting on a chair to breastfeed and utilized cross-cradle hold and baby-to-breast latch-on.