Breastfeeding: Optimizing Your Ergonomics and Posture
I have educated many moms during their physical therapy visits that good posture (and ergonomics) with repetitive tasks is essential to eliminating discomfort and avoiding injury. This article will describe how to do the same for yourself during breast or bottle feeding. When you have finished reading this post, I have attached a checklist at the bottom of the page for you to work through.
Related Articles:
Postpartum Essentials-everything a new mom needs for an easy transition from the hospital
Postpartum Exercise: The First Six Weeks
Dyspar-what-a? How to prevent pain during sex after birth
The number of employers that offer ergonomic assessments has increased significantly since I started practicing physical therapy. It’s actually pretty amazing how many workplaces value their employees’ comfort enough to spend the money on supplies that help prevent injury and support good posture (being a desk jockey does come with some risk, after all). And we know that having the right posture while working, as well as the tools to keep anything repetitive at the optimum angles, weight, etc., can make all the difference. If you think about it, sustaining the life of another human is essentially a full time job. So why not think about how to set up a space to use specifically for the purpose of breastfeeding? If you are able to use this space during at-home feeds, it allows for having a well-fitting and efficient space that minimizes potential risk for injury. And if you’re wondering how breastfeeding can contribute to injury, I would ask you to maintain a slouched posture for 20 minutes while holding a 5-10 pound dumbbell. Then try to stand up straight. Your mid-back is probably complaining a bit now, and you may notice your arms as well! Mid-back pain is the most common complaint I see from moms of babies less than one year old, but I have also seen tennis elbow, rotator cuff strains, and neck and low back pain depending on how moms are doing their feeds.
So, let’s get back to that thought of setting up a space that fits your body and needs: every parent or regular caregiver needs a place they can go to be properly supported while feeding baby. This is true even if/when you're bottle feeding! Initially, it is normal for a newborn to eat every 1.5 to 3 hours. This time is calculated from start of one feeding to the start of the next, and that’s a lot of time spent in the same position.
The way I recommend optimizing this situation is by setting up a breastfeeding station. This is a designated place in the house (baby’s room, parent’s room, wherever works for your family) that you will plan on going to nurse your baby. A breastfeeding station should consist of the following: a comfortable chair, support/nursing pillow, footstool (if you can’t comfortably touch the ground), and a side table all in easy reach. Your side table, especially in the newborn phase, should hold chapstick, nipple cream, breast pads, and snacks. And you will need a water bottle within reach because new moms get very thirsty (milk supply depends on water intake)! I have specific recommendations for some these products here:
Below is an example of how a few easy modifications can help your breastfeeding station fit to you. Your back should be fully supported by the back of the chair, and if your knees are right up against the edge of the seat after scooting back you may want to consider a little pillow behind yourself. This will help you feel less like you're dangling your legs in space and takes away the urge to scoot your hips forward in your seat, which will cause excess pelvic tilt and strain on the lumbosacral spine. If your feet have trouble reaching the ground in a resting position you will also want to consider a foot stool so that you can more easily rock and support baby safely (most important!). You are aiming for a resting position of hips and knees at about 90 to 100 degrees.
In the photo on the left, you can see that if I were to lean back I would have to lean really far backward to support my head, and that my shoulders are quite a bit forward from the backrest. This is not optimal because it will contribute to repetitive strain to my thoracic spine, neck and shoulders. My feet are firmly on the floor, but my knees are lower than my hips which makes it harder to support baby to bring her up to my chest. And the backs of my knees are in contact with the seat, meaning the seat is too long for me.
In the middle photo, I have added the nursing pillow and baby (and an extra toddler:)). You can see that my upper back appears even further from the backrest, and I am now up on tip toes to support the baby-to-chest position. I am also slouching to get support for my elbows to help hold the baby.
In the far right photo, I have a nursing pillow and a throw pillow supporting baby, which also supports me to allow resting in to the backrest of the chair. You can see in this photo that my shoulders are closest to the backrest and it would not be so far for me to rest my head, as I might for a night feed. Baby is also supported in a way that brings her to me, which is helpful both for safety (if I were to fall asleep) and to reduce the strain to my biceps and elbow flexors. With the two pillows along with a nursing footstool, I would probably not even need to bother putting support behind my low back, as that would lift my knees somewhat away from the seat of the chair. I did not have a footstool to show for the photo, but it should have been part of my ‘essentials’ set up as you can see.
*Apologies for the low budget photography, someday we will make it fancier!
Once you are comfortable in your position, add baby. In the workplace environment the resting position of the elbows and wrists are an important consideration, and it’s the same case in this scenario. You will need a pillow of some sort to bring baby up to you, and there are a few different styles on the market to choose from. I have found that for women with longer torsos there really is no perfect pillow, so I personally end up stacking a regular bed pillow or throw pillow under my Boppy. If I know for sure it's going to be a short feed session I will not bother with the second pillow and just pay attention to my posture, but when putting the little to sleep for the night I do use the two. It can be very challenging trying to put an infant to sleep calmly if you are at all uncomfortable!
Other New Mom Resources:
Clogged Ducts: home solutions for blockages during breast feeding
All About Pelvic Organ Prolapse
Postpartum Exercise: Beyond the First Six Weeks (plus strategies to avoid peeing your pants!)
Once you have the station set up, the next most important thing is to use it. After you've sat in your chair a few times you can see if any adjustments need to be made to accommodate any discomfort or fatigue you notice. Maybe a little taller foot support is necessary? Maybe have the side table closer for more easy placement of a bottle after a feed (remember, this is also appropriate for bottle feeding!) or your own water bottle? Keep in mind that ergonomics can, and likely will, change. As baby grows, he or she may need fewer or smaller pillow supports to reach your chest or comfortably rest on your lap. And baby may need a more quiet space to feed if you initially set up your station in a higher traffic area. Somewhere around 7 months they become really distractible and want to ignore feeding for any other activity! So know that nothing is permanent in the world of quickly developing infants.
Proper ergonomics for breastfeeding can be really effective in preventing repetitive-use injuries. Babies are hard to keep up with as they learn all of their new motor skills, and require healthy parents to keep up with them! So I hope you find all of this information helpful in keeping you healthy and pain free. And remember, as baby grows you may need to adjust your posture and station for feeding. Just as one station fits for a newborn and breast or bottle feeding mom, another may fit for an older baby and parent. Be flexible in your setup as life changes, but be consistent in using it.
If you would like to see some of the items I consider essential for the postpartum period, check out my Postpartum Essentials post!
If you have read this article and are still feeling discomfort, please consult a medical professional. You may need a physical therapist to look at your own set up to optimally fit it to you and your needs.
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