Why Lactation and OT?
I have spent a decade in an outpatient private OT/PT clinic and have found that so much of what I see with kids begins in the early days with their parents. Feeding, sleeping, and defecating are the primary occupations of an infant in these early times. What happens when one, two, or three of those areas are negatively impacted by one of the common infant difficulties (e.g. colic, food allergy/sensitivity, latch difficulties, milk transfer difficulties, or sleep issues)?
We all as humans develop a plan, mostly subconsciously, of how our typical routines need to be completed, or how to carry out an action. If something throws off our plan, how do we handle the change?
In these early days we as humans are gathering information about who holds us and soothes the discomfort, or who allows us to be upset. We learn how we get the support we need. We also create a new plan based on feedback we have gotten from our environment.
If, for example, we get milk out of a breast or bottle in a certain way and we were successful that way. Then no matter the impact on the feeding dyad, we will continue to use this strategy to get nourishment. Infants are notorious for using the easiest way possible to get food, which makes sense, why wouldn’t they.
This is why we see that maybe one side of breastfeeding is a preferred side, one bottle is a preferred bottle, one position of being held is preferred, etc.
BUT
When the feeding is too easy, think laid back bottle feeding with the bottle tipped all the way up. We don’t use any of the multiple muscles in our face to create the negative pressure to suckle. These muscles then do not get the practice necessary for chewing/swallowing later on. Without these muscles we then rely on a certain texture of food in later days, and thus begins a probable cycle of picky eating.
It all started with the latch and motor plan/motor learning in the early days. Scary? It can be, but it doesn’t have to be. This is where occupational therapy and lactation come together.
As a pediatric OT my job is to look at the occupation of feeding in the context of the environment (positioning, handling, sensory inputs), the person (dyad, latch, attachment/responsiveness, hand placement), and the results in the occupation of feeding. I work to find strategies to best support a healthy and comfortable feeding that can be replicated time and time again.
