How Physiotherapy Can Support Breastfeeding and Latch Challenges
- rainahawthorne
- Jun 2
- 3 min read
Written by Raina Hawthorne
Registered Physiotherapist
Feeding—whether at the breast, chest, or bottle—is one of the very first major motor skills an infant must master. While it often comes naturally, for many families, it can be a challenging and stressful journey when things don’t go as expected.
Feeding involves more than just hunger. Babies must create suction to initiate milk flow, coordinate their swallowing, and breathe smoothly throughout the entire process. This requires a complex interplay of muscle strength, joint mobility, reflex integration, and optimal positioning.
When Breastfeeding Is Difficult
Lactation Consultants and Lactation Doctors are a crucial part of the care team when feeding challenges arise. But when deeper mechanical or functional issues are contributing to the difficulty, additional support may be needed.
This is where Physiotherapy for breastfeeding can help.
A Physiotherapist trained in infant feeding and breast health can assess and support muscle coordination, joint function, and postural alignment in both the baby and the breastfeeding parent to optimize latch and improve the feeding experience.
The Phases of Infant Feeding
Feeding isn’t just about latch—it’s a full-body, multi-phase process. There are six distinct phases involved in successful infant feeding:
Active - rooting behaviours in the infant like moving their head side to side, opening their mouth, and sticking their tongue out as well as moving their limbs
Crawling - reflex driven actions that create movement (even in newborns) like wiggling, twisting, stepping movements, crawling, or even throwing their bodies
Familiarization - head bobbing, grabbing the breast/nipple, putting their hands in their mouths, latching and unlatching (it can be tempting to intervene here, especially as babe can sometimes look distressed, but this is an important step especially as they are learning!)
Resting - feeding is hard work for a little babe! so resting may happen at any point in the process, it's okay for baby to rest (without falling into a deep sleep), but expressing a drop of milk and talking to baby can help stimulate them back to focus on feeding
Suckling - baby latches on and begins suckling and swallowing (this is often the only part we end up focused on but it's actually just one out of seven different parts!)
Sleeping - once baby has taken in enough milk, they will typically sleep (this is a full, deep sleep, different than resting)
These phases are largely driven by primitive reflexes, and when steps are skipped—often unintentionally during rushed latching—it can interfere with feeding. In fact, research shows that how a baby gets to the breast can impact nipple pain just as much as how well they latch.
What’s Really Involved in a Latch?
More than 10 muscles in the face and neck contribute to suckling and swallowing—plus muscles in the trunk and limbs which provide postural support. The jaw must move fluidly for effective suckling, and stiffness in the jaw joints or surrounding muscles can cause babies to chew instead of suckle. Feeding reflexes are also key. Some reflexes, while helpful for motor development (like crawling), can interfere with feeding when triggered out of sequence.
Tongue ties and other tissue restrictions can further complicate feeding. While procedures to release tongue ties can be helpful for many infants, they may not resolve the issue entirely if underlying muscle or joint dysfunction is also present. Physiotherapy can help restore proper movement patterns and coordination in these cases.
How Poor Latch Affects Both Baby and Parent
Feeding challenges related to latch and mechanics can lead to a range of issues, including:
Nipple pain or damage
Low milk intake and poor weight gain
Breast pain, blocked ducts, or mastitis
Even for families choosing to bottle-feed, signs like milk leaking from the corners of the mouth, noisy sucking, or excessive gassiness may suggest poor latch mechanics—something a trained Physiotherapist can also help to address.
Physiotherapy Tips to Optimize Latch and Support Breastfeeding
Here are some foundational strategies to help support your baby's muscle coordination during feeding:\
1. Nose to Nipple: Align baby’s nose with your nipple before latching. This encourages the baby to tip their head back and open wide for a deeper, more effective latch and easier swallowing.
2. Belly to Belly: Support baby close to your belly/chest, holding their trunk up to the shoulders and base of their neck. This reduces the work of postural control so they can focus on feeding.
3. Avoid Pressure on the Back of the Head: Support baby’s head and neck with your forearm or a pillow, but avoid pushing on the back of the head. Too much pressure can disrupt the delicate alignment needed for feeding.
You Don’t Have to Struggle Alone
Feeding your baby shouldn’t hurt or feel impossible. If you or your baby are having challenges with latch, milk transfer, or bottle feeding, help is available.
Working with a Physiotherapist trained in infant feeding can be a game-changer—alongside your lactation consultant and healthcare team.
Contact us to learn more or book an assessment.
