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Inutero position - babies positions in the womb are space restricted by the end of pregnancy, and their bodies can adopt these positions as the “new normal” which can prevent normal, symmetrical movement and function of the baby’s head and neck.

Babies are designed to accommodate the natural birth process but some babies experience difficult, traumatic births; instrumental birth in particular can affect your newborn’s head, neck, and face . The forces exerted on the baby’s head, neck, and the jaw during the birth process can cause subtle interference of the neurological supply to the components of the baby’s feeding structures which can impair normal mechanical function of the jaw and soft palate and result in a poor vacuum during feeding. Added mechanical stressors during birth like vacuum or forceps to aid delivery can exacerbate the mechanical forces experienced during birth.

Evidence of pain in your newborn can show when you cuddle them, pick them up, while dressing, particularly when their arms are pulled through sleeves. These babies are happiest being left to lie flat on their backs and can refuse to lie on one side because of pain on that side, making it difficult to feed. They can be especially difficult to calm once upset.

2) FUSSY FEEDING

If your baby latches on and feeds well only to pull off promptly, crying in a distressed way, pain may be the cause. This can look like “fighting” at the breast and switching to a pain free position can make feeding possible short term. If your baby will only happily feed with their head/ neck facing the same direction (cradle hold one side and football hold other side) chances are there are joint restrictions causing pain which is distracting your baby during feeds. This behaviour is always more noticeable at the end of the day when baby is more tired.

A give- away sign of trouble to come is when newborns have an abnormally strong neck from birth. This appearance of a strong neck is a result of dural tension and not a sign your baby is advanced. The dura attaches at the upper part of the neck and in the lower back at the sacrum. Rotation in the newborn’s pelvis will cause tension in the neck but taking out the dural “slack” which makes it appear as if the new-born has an extraordinarily strong neck. This type of tension will also manifest as a baby that just wants to be held all the time, as this reduces the tension compared to when positioned with a straight spine. Typically, these babies fall asleep in your arms and then wake up the instant you try to lie them down to sleep in their cot.

Shortly after birth babies often favour a head position or gaze to one side, causing a flat spot on the back of the head from the continuous pressure. This flat spot becomes what is called plagiocephaly where the cranial plates shift resulting in an asymmetrical head shape. The internal structures of the skull like the cranial nerves and the eustachian tubes of the inner ear are not designed to elongate to accommodate asymmetrical and shifting cranial plates. It is imperative that babies get treatment within the critical first four- month window period while their skulls are still soft and pliable, or the skull asymmetry can require baby to wear a helmet for correction later. There are three typical shape presentations of plagiocephaly, which have been noted in the new literature to be associated with a developmental delay, increasing the urgency to get the issue addressed sooner rather than later.

3) SORE AND DAMAGED NIPPLES

There are many potential causes of nipple pain and damage, most of which are outside the scope of this article. If the damage is caused by your baby finding a deep latch painful, then chiropractic adjustment can help.

Collaborating with a supportive multidisciplinary team is important and sometimes it takes a little bit of everything to get the feeding right. When babies have had their tongue tie snipped and are still struggling to feed, some pain free rehabilitation and chiropractic care can be beneficial to get those neurological pathways to the brain firing more effectively.

4) CLICKING WHILE SUCKLING

Babies can present with dribbling of milk or making clicking noises while latched and suckling. This is most commonly due to neuromusculoskeletal impairment causing weak vacuum, or a floppy soft palate. Impaired temporomandibular joint (TMJ) range of motion and muscle imbalances can limit or impair the baby’s ability to latch effectively and create a vacuum.

There are 3 cranial nerves which govern the muscles of the pharynx, palate, and tongue; all of which facilitate the complex mechanism of sucking, swallowing and breathing in young infants. A 4th cranial nerve that contains all the sensory fibres supplying the mouth and tongue also supplies some muscles of mastication. It is thought that cranial and upper cervical restrictions (which can influence the cranial nerves through the upper cervical ganglia and can lead to neurological dysfunction) results in motor imbalance in these muscles; or in the case of the sensory nerve, the baby could experience facial pain while sucking.

Chiropractic adjustments treat joint dysfunctions which improve overall communication between the central and peripheral nervous system, thereby optimising function of the nervous system. It is thought that the regulation has influence on somato-autonomic reflexes and can switch the nervous system from a stressed, sympathetic state to a rest and digest, parasympathetic state which is why babies are always much calmer after being adjusted.

The best course of action is to get babies assessed while they are still young, as the problems are easier to fix. Get on top of any pressing issues and make use of all the professionals available to get through the difficult periods more quickly and with greater ease. Breastfeeding struggles don’t need to become insurmountable and in many cases can be resolved.