Osteopathic manipulative treatment for management of feeding dysfunction in breastfed newborns

The benefits of breastfeeding are well established, from reduced incidence of common childhood infections to decreased incidence of sudden infant death syndrome and infant mortality. Offering support to breastfeeding mothers should be a key aspect of care in the perinatal period.

The purpose of this study was to evaluate whether utilization of a standardized osteopathic manipulative treatment (OMT) protocol as an adjunct to lactation support improves feeding dysfunction in breastfed newborns.

This was a single-blinded, randomized, controlled, prospective pilot study of healthy, full-term neonates identified by an International Board Certified Lactation Consultant (IBCLC) as having feeding dysfunction. Neonates were subsequently randomized in an alternating fashion into an OMT protocol treatment vs. sham treatment. Infant LATCH (Latch, Audible swallowing, Type of nipple, Comfort of birth person, and Help birthing person needs holding infant to breast) scores were assessed by nurses and IBCLCs during hospitalization assessed with mean and median score improvement between groups.

Forty infants were included in the study, divided into a sham group (n=21) and OMT group (n=19). The groups had similar characteristics. The change between pre- and postintervention LATCH scores were calculated for each group, respectively. The mean LATCH score change in the OMT group was 2.0±1.8. The mean LATCH score change in the sham group was 0.9±1.2. The mean LATCH score change in the OMT group is statistically significantly greater than the mean LATCH score change in the sham group (p=0.030), indicating that the OMT group had greater improvement in their LATCH score compared to the sham group.

Healthy newborns with feeding dysfunction who were randomized to receive two OMT treatments during their hospitalization demonstrated a statistically significant moderate improvement in the changes in the median modified LATCH score compared with newborns randomized to the sham group. However, the effect size was moderate, at best. The LATCH score changes between groups cannot be highly attributed to the OMT interventions. However, there were no adverse effects of treatment. These findings suggest that OMT may be a safe adjunct to traditional lactation support in the care of healthy breastfed newborns with feeding dysfunction. Future studies could investigate other factors, such as the length of time that mothers breastfeed their infants after the two initial treatment sessions or potentially including a separate arm for neonates with ankyloglossia.