Friday, July 15, 2011

Physical therapy offers hope for women with breastfeeding struggles

This is an article I wrote a couple of years ago for The Scribe, a Portland-based medical publication. I'm posting here because it ties in to a post I'm working on as we speak.

For some new mothers, breastfeeding is frustrating. It hurts. The baby won’t latch. The milk runs dry too quickly, and infections develop. Despite their desire to breastfeed, it might seem easier to just give up altogether. But there is another solution — physical therapy.

“Our patients call it a miracle cure,” said Doris Onnis, a board certified lactation consultant who works at Providence St. Vincent Hospital.

Obviously, Onnis isn’t referring to traditional physical therapy. Mothers won’t walk away from their sessions with lists of exercises to do at home. Instead, they’ll walk away with renewed hope in the whole breastfeeding process. It all begins with a consultation with Onnis or one of her colleagues, who teach new mothers about proper positioning and other breastfeeding basics. For many women, this does the trick. Sometimes, however, they need more assistance. This is where the physical therapist comes in.

“If we refer a patient to physical therapy, it means we have ruled everything else out,” Onnis said.

In other words, by the time a patient gets to physical therapy it is pretty obvious that the position is not the only problem. More likely, blocked milk ducts or mastitis are to blame. Through the use of low-wattage ultrasound, the physical therapist helps break up the blockage and/or clear the infection. Usually, this allows the mother to successfully breastfeed — in some cases for the very fist time.

How does it all work? Well, in the case of a blockage the sound waves of the ultrasound encourage the fluid start moving. Same goes for a mother with an infection — the necessary nutrients start making their way into the milk duct while the waste products are simultaneously eliminated. The therapist also makes sure that, during the ultrasound, the mother remains in proper position.

“We position them so that there is drainage, in the line of gravity,” said Nora Stern, MSPT, a Providence-based physical therapist who sees many of Onnis’ patients.

The treatment is not painful, Stern said. The most difficult part is scheduling — most patients need two treatments twice a day for three consecutive days. Plus, patients need to nurse within 20 minutes of receiving the treatment.

“They either bring in the baby or pump,” Stern said.

Stern said patients are also instructed in post-treatment self-care. For example, they are encouraged to continue using the techniques they learned from their lactation consultants, along with new techniques such as placing a warm compress over a once-blocked duct. Because the treatment almost always results in “very rapid change,” Stern is extremely cautious when a patient’s situation does not improve right away.

“If we don’t get the rapid response that we expect to see, we send them back to their doctor right away,” she said.

She also emphasizes that, for mothers with mastitis, physical therapy is designed to complement — not replace — other treatments.

“Before we treat them, they need to be treated with antibiotics,” she said. “Otherwise (the infection) could potentially spread because the ultrasound promotes blood flow.”

Onnis said one of the biggest challenges she and her colleagues face is simply getting the word out.

“We’re (working on) educating providers, which we hope will create an awareness,” said Onnis, adding that the physical therapy treatment does require a physician referral.

She also explained that they try make it easy for doctors to get their patients in for treatment, which she hopes will encourage more and more physicians to send their patients over.

“One advantage is that we are (available) on weekends,” said Onnis, referring to both the lactation consultants and the physical therapists. “Providers can feel free to call us the same day and get (their patient) looked at.”

Though Onnis and Stern are based at Providence’s St. Vincent campus, the treatment is available at several satellite offices throughout the Portland area.

1 comment:

  1. Speaking from experience (I nursed my girls for a total of 21 months, 9 of them exclusively), the best way to ensure success is to educate yourself before the baby comes. It might be natural, but most of us don't have mothers/sisters/aunts to show us how. Most problems can be avoided if you understand the physiology of milk production, the growth rates ,nutritional needs, and natural feeding schedules of infants, and the correct way to get the baby to latch. That and good self care takes care of most common problems (there are of course rare medical issues).

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