A Physical Therapist’s Guide to Comfortable Breastfeeding

Breastfeeding can be a real pain in the neck...literally!

Here are our best tips for easing aches and pains that commonly occur when breastfeeding our littles.

Whether you’re a first timer or a veteran mom, each post-partum phase of life poses new and challenging considerations. If you choose to breastfeed your baby, you will experience the deepest connection and love during this magical time. However, many moms also experience significant discomfort during and after breastfeeding. 

Maybe you've stocked up on nipple butter, a breastfeeding pillow and, found great books or podcasts for all those hours spent nourishing your baby, but you may not have prepared for that pain you will develop in you neck, shoulders, back, hips, and pelvis as a result. The good news? We can help!  

Why do moms develop chronic pain in their body when breastfeeding?

Women spend several hours per day breastfeeding, pumping for their newborns, or both. Spending so much time in difficult positions can take a toll on the body! It's important that you vary your positions, use tools like pillows and blankets used for positioning, and regularly engage in exercises and movement to ensure your neck, shoulders, back, hips, and pelvic floor don't wind up stiff, painful, or sore. Ensuring your spine, shoulder, and hip joints are aligned properly is critical for those long periods of time and help you nerves send signals to "distal" (further away) body parts. Many women experience tingling in hands, wrists, and feet during or after breastfeeding.

Luckily, there are tools and movements that can help both preemptively, during, and after all those feeds. With the proper pillow and towel set up to help keep your body in neutral positions, varying breastfeeding positions, and the proper combination of movement/exercise, you can be equipped for success.

Positioning during breastfeeding

A combination of pillows and towels to create the optimal position for breastfeeding will help ensure your ideal alignment without having to hold your arms or any other body parts in place, adjust constantly, or start to feel symptoms like pain or tingling.

Take breaks! Every few minutes, make sure to take breaks to stretch, rotate neck both directions, up and down, take some good deep breaths, hydrate, and check your posture for ideal alignment.

What is the ideal position and body alignment for breastfeeding?

1. Ensure your position is "Pelvic neutral"

   
   

   It’s no surprise that as pelvic health specialists, we’re starting here.

   Pelvic neutral positioning means your sit bones are on the chair with weight going through each side equally. Try not to cross your legs. Pelvic neutral is between full slouching (posterior pelvic tilt) and arching forward (anterior pelvic tilt). Your feet should be on the floor with knees and hips at about 90 degrees.

   
   

2. Choose the right chair

   
   

   Your chair should allow for neutral positioning throughout the spine (see illustration below) and on a surface that isn’t too hard. Even in a pelvic neutral position, sitting for too long on a hard surface can start to make your pelvic floor and the nerves that go through it very unhappy!

   
   

3. Ensure your position is "Spine Neutral"

   
   

   Keep your Neck relaxed and straight. While it may be tempting to stare at your precious newborn the entire feed, it's important to keep your neck in a neutral position when breastfeeding or bottle feeding. No looking up or down for prolonged periods of time.

   Focus on the posture of your low back. If your pelvis is already in neutral, this will be much easier. The lumbar spine, or low back, should be in a position with a little bit of curvature. You don’t want to be slouched and you don’t want to accidentally slide into a slouched position while breastfeeding. Depending on your chair, a small pillow or towel roll behind your lumbar can help achieve this.

   
   

   You might like a McKenzie Roll!

   
   

4. No straining the hands or wrists

   
   

   Bring the baby to the boob, not the other way around.

   Pillows or a chair with armrests that keep your arms, shoulders, and hands at neutral height will eliminate that “shoulder in the ears” feeling that results in those tight upper trap muscles on top of your shoulders.

   
   

   Make sure to check baby’s position throughout to ensure your hands and wrists aren’t twisting and grasping to bring baby closer to you.

By following these guielines, you can achieve good posture and alignment in most seated breastfeeding positions as well sidelying breastfeeding positions. If you have any questions or difficulties with positioning, alignment, or these exercises, try a free discovery call with one of our highly trained pelvic and women’s health doctors of physical therapy!

Helpful exercises for pain prevention and relief during breastfeeding

1. Cat cow

   
   

   Start in "quadruped" (on hands and knees) with weight distributed evenly between all 4 limbs (AKA tabletop position). Starting at the pelvis and moving towards the lumbar spine, move each vertebra one at a time arching the back up (like a cat). Continue until you reach the head, which ends in a tucked under position. Hold for 3-5 seconds. Remember to breathe throughout. Reverse the movement, starting with the head down to the upper back curving back down the other direction, ending with an arch downward. *careful with this movement if you have a "diastasis," (ab separation). If you notice doming/bulging between the abs, stop this movement at a neutral/flat back or right before the doming. Come see us for help with exercise modifications for diastasis and to help close the separation! Repeat about 10 times in each direction. 

   
   

2. Foam roller

   
   

   Lie on a long foam roller vertically (roller should be along your spine) supporting your spine all the way from your tailbone to your head. Perform a TA hold (see below) to stabilize deep core so that low back isn’t arching when performing these movements. Perform “snow angels” with palms facing up towards ceiling. Move slowly and stop when you feel stretch in the chest/front of the shoulder. Hold this position for 30-60 seconds, decreasing the stretch or resting if you feel pain, numbness, or tingling. 

   
   

3. Open/close book rotation

   
   

   Sidelying on either side first with your knees bent to a 90 degree angle and hands together out in front of you, slowly and with control “open the book” by rotating your arm out to the opposite side, with your head following the top hand until you feel a stretch (forming a T shape with your arms). Hold for about 5 seconds, repeating about 10 times on each side.

   
   

4. Transverse abdominis (TA) hold

   
   

   This one is tricky and can be done in several positions. To learn how to properly feel a TA hold, laying on your back with knees bent is usually the easiest position to start with. Gently pull your pelvic floor upward towards head, belly button in towards spine, and exhale. The TA muscle is your “corset” muscle, so it should feel like you are gently tightening a corset. Repeat 20 times with a 5 second hold.

   
   

5. Back strengthening with bent over rows and reverse fly

   
   

   Check out this video from fellow pelvic health physical therapists for some great tips on this!

Looking for help with other general breastfeeding issues?

If you are experiencing issues with latching, have questions about the frequency and duration of breastfeeding, or have questions or concerns regarding lactation, please consult a certified lactation consultant!

These are general recommendations and should not be taken as medical advice. In order to receive a program tailored just for you, see one of our physical therapists for an individual assessment, evaluation, and treatment!