Assessment of the Efficacy of An Osteopathic Treatment in Infants with Biomechanical Impairments to Suckling

Summary

Osteopathy is an emerging field of clinical research. Here we present a protocol to assess the efficacy of an osteopathic intervention coupled with lactation consultation, in infants with biomechanical issues impeding breastfeeding.

Abstract

Breastfeeding can be challenging for mother-infant dyads experiencing biomechanical suckling difficulties. Although lactation consultants (LCs) all over the world have increased their skills in this field and can provide support to help position the infant at the breast, the impact of their intervention might be limited in the presence of stiff structures in the infants. Here we present a protocol for a randomized controlled trial to assess the efficacy of osteopathic treatment, coupled with lactation consultation, for infants' biomechanical suckling difficulties. It proposes a set-up and a sequence of actions to ensure an optimal context for treatment, as well as a blinding of parents and LCs to the intervention. Data such as the infant's latch ability measured with the LATCH Assessment Tool, the mother's nipple pain with a visual analog scale (VAS), and the mother's perceptions are collected by LCs four times over a 10-day period. Osteopathic lesions are documented by the osteopath, using a standardized assessment grid. Structures of interest are coherent with the anatomical zones involved in latching onto the breast. This protocol also proposes a strategy to document systematically an osteopathic profile of infants with biomechanical suckling difficulties in their first weeks of life. The implementation of this protocol confirms its feasibility for osteopathic assessment and treatment and paves the way for future trials to further explore the efficacy of osteopathic techniques for infants with biomechanical suckling difficulties.

Introduction

Over the last thirty years, international recommendations from the World Health Organization¹, followed by national recommendations in many countries^2,3,4, have advocated for breastfeeding. Its health benefits are now well-known^5,6 and breastfeeding exclusively for the first six months of the infant's life and maintaining it for two years or longer is described as the norm¹.

As highlighted by Homdrum and Miller⁷, mo....

Protocol

This randomized controlled trial protocol was approved by the Comité d’éthique et de la recherche en santé de L’humain at the Centre hospitalier Universitaire de Sherbrooke and the Comité d’éthique et de la recherche at the Centre intégré de santé et services sociaux de la Capitale Nationale in Québec City, Canada.

1. Identification of Collaborators and the Preparation of Recruitment

1. Network with LCs and/or a local mother-to-mother support groups where frequent lactation consultations are provided in order to identify where the study will take place.
2. Organi....

Results

Ninety-seven mother-infant dyads were recruited and randomly assigned to one of the two study groups. The participants' characteristics and delivery mode are summarized in Table 2. Only 1/3 had a natural birth, meaning that the other 2/3 experienced epidural and vacuum (15.9%), forceps-assisted (2.9%), or C-section (18.8%) births. In this study, all infants had skull lesions (Table 3). The posterior quarter represented by the occipital and the tempora.......

Discussion

This study is one of the first randomized controlled trials to assess the efficacy of an osteopathic treatment for infants with biomechanical suckling difficulties. When performed promptly, this intervention might reduce the risk of stopping breastfeeding earlier than originally intended.

With no prior models, this trial was designed pragmatically, including the need to act quickly to address breastfeeding difficulties and nipple pain that may be experienced with a newborn. The protocol also m.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
sofa or armchair			comfortable enough for a new mother with potential ceasarean section scar to stay half an hour with the infant in her arms and comfortable enough for the osteopath to perform the intervention
cushion			to put the infant on it and helpful if required,  to breastfeed the infant
Goniometer	Dufort et Lavigne or similar	ALM 324000	in smooth plastic, not too long to be handle with one hand