Physiologic Breastfeeding: A Contemporary Approach to Breastfeeding Initiation.

Early initiation of breastfeeding has numerous benefits for maternal-child health. Maternity care providers have been shown to play a significant role in establishing breastfeeding, yet there is limited research about clinical approaches that support breastfeeding initiation in the immediate postpartum. Traditional methods that focused on position and attachment have not demonstrated consistent, positive effects on breastfeeding outcomes. Contemporary approaches to breastfeeding initiation emphasize innate maternal and neonatal breastfeeding abilities and the importance of breastfeeding self-efficacy, dyad-centered care, and a supportive breastfeeding environment free from unnecessary interventions. Recommendations for clinical practice for physiologic breastfeeding initiation are provided.

Breastfeeding infants with congenital torticollis.

Infants with unilateral sternocleidomastoid tension and associated craniofacial, spinal, and hip asymmetries may feed poorly. Anatomic and muscular asymmetry stress both biomechanics and state control, increasing the potential for difficulty latching and sucking. A combination of positioning modifications to allow the infant to maintain his or her comfortable head tilt and turn, supportive techniques to restore alignment of oral structures, and handling techniques to help activate the weak contralateral muscles have been effective in the author's practice. Lactation consultants can promote positioning and muscle activation strategies and encourage physical therapy referrals for infants who do not respond promptly to reduce the risk of craniofacial deformity and developmental problems.