Osteopathic Manipulative Treatment for the Breastfeeding Dyad: A Scoping Review

Human milk is widely recognized as the optimal source of infant nutrition. While 83.9% of mothers initiate breastfeeding, only 46.3% exclusively breastfeed to 3 months. Common barriers include latch and suck difficulties, painful feeding, and breast infections or engorgement. Osteopathic manipulation, including osteopathic manipulative treatment (OMT) and therapy (OMTh), has been proposed as supportive intervention for breastfeeding challenges.

This scoping review examines the current literature on OMT/OMTh in the breastfeeding dyad and identifies gaps to inform future research.

Seven databases were searched for studies involving OMT use in infants under 24 months and breastfeeding parents. Titles and abstracts were screened, and eligible full-text articles were extracted and analyzed for themes. Data included study characteristics, osteopathic intervention, and reported outcomes. As a scoping review, formal quality and risk of bias assessments were not conducted.

Of 9,141 articles screened, 35 met inclusion criteria (three focused on breastfeeding parents, 32 on infants). Among the infant studies, 19 studies included a feeding related outcome-seven involved healthy term infants, and eight on hospitalized preterm infants, one on infants with encephalopathy, and three case reports discussed OMT use in complex feeding scenarios (i.e., oral aversion, esophageal atresia, Pierre Robin Sequence). Five studies were on infants with colic, six on plagiocephaly, and two on postural strain and torticollis.

Preliminary evidence suggests OMT may support feeding-related outcomes in the breastfeeding dyad (e.g., latch dysfunction, low milk supply, mastitis). Further interdisciplinary research is warranted to clarify its role and inform clinical practice.