Breastfeeding, Lactation, Mastitis & Tongue Tied
At Guelph Women’s Health Associates, we offer lactation education and support through the means of a Certified Lactation Counselor. We offer these services to new parents during the entire feeding process for your infant: breast/chestfeeding, pumping, bottle feeding, and starting solids. This is a challenging and unfamiliar time for many parents, and having the encouragement and knowledge to successfully feed your baby is extremely beneficial. Our goal is to help these new parents and babies to meet their feeding goals.
We offer these services through a Certified Lactation Counselor (CLC). A CLC is someone who has completed specific lactation education and passed an examination. CLCs are committed to the education, assistance, and use of problem-solving skills to aid with breast/chestfeeding, bottle feeding, pumping, and starting solids.
Meet Megan Bendfeld, Certified Lactation Counselor
Megan is a Certified Lactation Counselor and has a Bachelor’s degree in Family and Social Relations from the University of Windsor with a concentration in gender studies. Megan achieved her certification from the CAPPA Academy and is committed to helping new parents with all things feeding. Megan does not just focus on breast/chestfeeding but also pumping, bottle feeding, and starting solids. She takes an approach to help families through education, support, and using her problem-solving skills to reach their feeding goals. Megan continues her education by working towards becoming an International Board Certified Lactation Consultant from the Newman Clinic. Megan is dedicated to helping everyone feed their baby as a fed baby is best!
The journey of breastfeeding can be incredibly beautiful, but also incredibly challenging. Many breastfeeding dyads struggle with things like latch and positioning, nipple pain/damage, blocked ducts and mastitis. Physiotherapists have not traditionally been first-line support in helping breastfeeding families to resolve challenges, however, physiotherapists with the right training in breastfeeding-related conditions can play an important role in helping families to reach their breastfeeding goals. There are two main areas in which physiotherapists can help breastfeeding families: the treatment of blocked ducts and mastitis, and the assessment and treatment of conditions of the jaw, mouth and neck.
Mastitis is a very common condition in lactating women that can occur at any time during lactation, but most often occurs during the first six weeks postpartum. Mastitis is often clinically defined as a tender, red, swollen area of breast tissue, associated with flu-like symptoms, and a temperature of greater than 38.5 degrees C. However, the literal definition of mastitis refers to any inflammation of the breast, which may or may not be caused by a bacterial infection. Areas of breast engorgement, or “blocked/plugged ducts” can also present with redness, swelling and pain, though an infection is not necessarily present. Prompt treatment of blocked ducts and mastitis is important, as evidence suggests that there is a progression from breast engorgement or blocked ducts to non-infectious mastitis, to infectious mastitis to breast abscess.
The physiotherapy treatment of blocked ducts and mastitis involves a technique called therapeutic breast massage. The breastfeeding parent is positioned in a comfortable position, and the therapist uses stroking motions starting at the areola and moving towards to armpit. The pressure applied is initially very light and becomes more firm as tolerated. This is alternated with the hand expression of milk to clear the area of milk stasis. The goal of therapeutic breast massage is to aid in fluid drainage towards the local lymph nodes. Some physiotherapists will also use ultrasound to reduce inflammation and help clear areas of milk stasis. The physiotherapist will also provide education on symptom management at home, including heat/ice, self-massage and positioning, as well as guidance on when to return for further treatment, and when to seek care from a physician.
There are several infant factors that can also contribute to breastfeeding difficulties, such as tongue and lip ties and torticollis. In tongue and lip ties, the tissue connecting the tongue and lips to the mouth is shortened, tight or thickened, leading to impaired mobility. This can affect how well an infant is able to latch on to the breast, as well as how efficiently they can transfer milk while breastfeeding. A physiotherapist can use a screening tool to help identify the presence of a tongue or lip tie, and refer a breastfeeding family to a practitioner that is able to release these tissues (often a family doctor, pediatrician or dentist). A baby who has had a tongue or lip tie may also develop tightness in the muscles of the jaw and neck because of the altered suck mechanics necessary to breastfeed without proper tongue and lip mobility. A physiotherapist can use gentle soft tissue techniques and stretching to normalize the tone in these muscles.
Congenital Muscular Torticollis occurs when an infant is born with a restricted neck range of motion because of tightness in the sternocleidomastoid muscle. The infant’s head may rest in a rotated or side-flexed position due to this tightness, which can then lead to difficulty achieving a good latch. A physiotherapist can help to identify when torticollis is present, and treat it with stretching and soft tissue techniques as well as provide the parents with a home stretching and strengthening program, and tips on positioning and tummy time.