Medical Student Rowan Virtua School of Osteopathic Medicine Monroe, New Jersey
Background and Hypothesis: A scoping review was conducted to review the current literature available regarding the use of Osteopathic Manipulative Treatment (OMT) in breastfeeding mothers globally. This research can potentially help alleviate physical discomfort, improve the breastfeeding experience, and promote maternal well-being through an evidence-based, holistic approach. We hypothesize that OMT use in breastfeeding mothers may result in a reduction of musculoskeletal discomfort, improve breastfeeding discomfort, and enhance maternal well-being.
Methods: A systematic search of PUBMED, Web of Science, EMBASE, Scopus, and Cochrane was conducted. The search was not limited by the publication date or the country where the studies were conducted. Keywords 'Osteopathic manipulative treatment' and 'breastfeeding' were utilized as search terms. Inclusion criteria included OMT treatment modalities, English language, peer-reviewed, free-to-access articles, reported outcomes such as subjective patient experience, and objective clinical measurements. Articles were screened initially at the title/abstract and full-text level. Two independent reviewers (MS and SS) conducted the initial screening. In cases where consensus could not be reached, a third reviewer (AD) was consulted as a tie-breaker to make a final decision. All three reviewers independently extracted relevant data from the included articles. The extracted data were analyzed descriptively to map the results.
Results: Rationale for OMT: The articles mentioned that treatment with OMT should be based on biomechanical restrictions to increase blood flow and lymphatic return. Multiple articles utilized techniques such as myofascial release, cranial OMT, balanced ligamentous tension, soft tissue manipulation, and inhibition pressure. Neonatal Outcomes: The mean LATCH Score was significantly higher in the infants receiving OMT (p < .001). Additionally, individual L and H scores were significantly higher (p < 0.037; p< 0.032). The individual A, T, and C scores, however, showed no significant difference (p=.078, 0.076, and 0.234, respectively). In addition, there was a significant decrease in the timing of feeding for those who received OMT (p=0.042). Maternal Outcomes: There was no significant difference in nipple pain between the treatment and control groups (p=0.713). There was a significant difference in maternal perceptions of time related to the initiation of breastfeeding from the neonate including biting the nipple, opening their mouth, and trouble latching onto the nipple (slippage) (p =0.042, p=0.016, p=0.002).
Conclusion: Osteopathic Manipulative Treatment shows promise in improving neonatal outcomes as indicated by a notable increase in latch quality and breastfeeding success in patients receiving OMT, particularly L and H scores. Additionally, OMT decreased the timing of feeding, suggesting a potential impact on breastfeeding session scheduling. While it did not significantly reduce nipple pain, these findings support OMT’s potential as a valuable intervention for breastfeeding mothers with respect to the role of enhancing latch quality, improving infant feeding dysfunction, and infant feeding time. Further research is needed to understand the effectiveness of OMT as an intervention for improving breastfeeding for infants and mothers.
Acknowledgement of Research Study Sponsors and IRB: Due to the nature of the research being a scoping review with no direct human contact, this study is IRB exempt.
