Extrapolating traditional bodywork therapy back to breastfeeding babies isn't consistent with evolutionary and neurodevelopmental science nor with breastfeeding as a global health priority
Traditional bodywork false assumption #1: approaches which show good outcomes for adults and children can be extrapolated back and successfully applied to babies
Adults like me have had years or decades of dysfunctional movement patterns, developing low-grade tissue inflammation, fascial contractions, and muscle knots. But traditional bodywork takes important principles which are relevant to an older child, adolescent or adult body, and extrapolates these principles back to the body of a baby, who is freshly out of the womb and at a very particular developmental phase.
This extrapolation from adulthood or later childhood back to infancy fails to understand the specific developmental phase of a newborn or baby's brain, body and tissues.
It has happened a lot in the practice of medicine over my professional life: interventions which are appropriate for older children or adults have been extrapolated back and applied to infancy, without regard for the very unique developmental needs and biological realities of a baby in the first year of life.
This kind of extrapolating back from scientific discoveries which are helpful in later childhood and adulthood to infancy is a main reason why there has been so much overdiagnosis and overtreatment of babies who are unsettled or who have breastfeeding problems throughout the course of my professional life.
What does evolutionary biology tell us?
The human infant is born an 'exterogestate foetus', most usefull understood physiologically in the context of the loving maternal or carer's body. This means that the Homo sapiens infant in the first year of life is only able to be understood - and treated - as a physiological extension of the maternal body.
You can find out about the single biological system of the breastfeeding mother and baby here.
Traditional bodywork assumption #2: infant tissues are as prone to stuckness, joint compressions, and inflammation as adult tissues
Traditional bodywork therapists identify a wide range of pathology in breastfeeding babies, which they suggest is not identifiable by doctors because doctors are blind to subtle functional nervous system health. I acknowledge that my own profession has been rather blind to musculoskeletal function and implications for health for much of my professional life. You can find out about this here.
What does evolutionary biology tell us?
Dysfunctions and fascial contractions build up in the human body over time, after months and years of dysfunctional or asymmetric movement patterns.
But our newborns and babies have fresh and supple tissues, unwritten upon, easily reconfigured by the constant return to the maternal body and joyful engagement in rich environment experiences and interactions.
The human infant fascia is not characterised by the kind of contractility and stuckness that we see in adult fascia. A baby is born with fresh connective tissues and with fascia that is supple, adaptive, stretchy, pristine. Infant tissue is not prone to the same knotting or stuckness in the fascia that we find in older children and adults. There is no role for stretching infant connective tissue, as stretching won't change what is already fresh and healthy tissue.
Traditional bodywork assumption #3: the infant suck and tongue movement have fixed action patterns which go wrong and take weeks or months to re-wire or reset
Infant muscles can develop asymmetric movement patterns, whether due to damage or influences in the environment (e.g. baby lying on her back looking towards the door for long periods, associated with a positional plagiocephaly. You can find out about this here). However, these movement patterns remain highly plastic, and are shaped in response to context (e.g. fit and hold, postural positioning).
Evolutionary bodywork therapy proposes that exercises applied for a period of time a number of times a day to the infant muscles, joints, and tissues can't be expected to change infant neuromuscular patterns.
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Infant oromotor function needs to be understood in the context of whole of infant body (positioning, motoric stability, spinal aligment) and the maternal body.
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If the context isn't changed, then the neuromuscular function won't change (unless the infant is gradually maturing and growing in size, which impacts on function).
You can find out why the tongue usually doesn't have dysfunctional movement patterns causing breastfeeding problems the way you might hear.
What does evolutionary biology tell us?
Evolutionary biologists tell us that the human infant has fewer fixed action patterns than any other primate or mammal, and is breathtakingly neuroplastic and responsive to context or environment.
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The human infant is characterised by neoteny, a uniquely human developmental plasticity.
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The environmental context determines how the few reflexes that we are born with actually respond to input.
What does neurodevelopmental science tell us?
I share the view of the growing number of developmental researchers who argue that tiny motor injuries or problems in the infant brain can have a cascading effect on all facets of infant development.
It's also increasingly widely accepted now that the best way to repair many developmental challenges is by using the small child's desire or emotional drive or intention to drive new patterns of motor behaviour and interaction.
Traditional bodywork assumption #4: the infant body is incompetent
Traditional bodywork for babies is built from a belief in the incompetence of the breastfeeding infant, which needs to be fixed by a course of manual therapy. There are two reasons given.
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The infant body is incompetent to breastfeed because baby is born incompetent
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The infant body is incompetent because of baby is damaged in childbirth.
What does evolutionary biology tell us?
Evolutionary biology teaches us that human anatomy and breastfeeding has been remarkably stable for the past three hundred thousand years. Every child born carries the robust genetic coding of the past four billion years of evolution of life on earth. Each little one who arrives in our arms is the epitome of the evolutionary development of life on this planet. Evolutionary bodywork has confidence in the evolutionary integrity of the human infant and his mother. (Here we are not considering those mother-baby pairs who are dealing with medically diagnosed conditions and illnesses.)
Traditional bodywork assumption #5: perfection of symmetrical function is achievable with enough treatments and exercises
I contest the belief in physical perfection, the belief that perfect symmetry, perfect function, can be achieved with the right exercises. This belief is accompanied by the beliefs that
The bodyworker can fix the imperfection with multiple consultations
The parent can be taught by the bodyworker to fix this, with regular application of exercises on the baby.
The dominance of traditional bodywork therapy in clinical breastfeeding support arises out of a powerful groupthink within various breastfeeding support professions in advanced economies
Folks look at me incredulously when I say there is no role for traditional bodywork therapy in helping babies with breastfeeding problems. So many people believe in the importance of traditional bodywork therapy for breastfeeding babies around the world, so much work has gone into it, so many conferences, such detailed teaching, that a dissenting voice is scoffed at as ignorant.
Except of course, this kind of overservicing is a worsening global problem. You can find out more about it here.
What do studies in global health tell us?
Overdiagnosis, overtreatment, and overservicing is particularly common in affluent societies. I have watched two other great waves of overdiagnosis and overtreatment occur internationally in breastfeeding mothers and their babies in my life-time. Vast amounts of money invested have been invested in conferences, methodologically weak research studies, and unnecessary and inappropriate treatments of reflux and allergy in breastfeeding babies. I now see this occuring for the diagnosis of fascial restrictions in breastfeeding babies.
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You can find out about overdiagnosis and overtreatment of reflux here.
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You can find out about overdiagnosis and overtreatment of allergy here.
I believe that in ten or twenty years time, traditional bodywork therapy will no longer have a prominent place in breastfeeding support, as more effective methods for helping breastfeeding women and their babies, such as I offer you in Possums Breastfeeding & Lactation, become available.
Recommended resources
Who gives traditional bodywork therapy to breastfed babies and why?
Breastfeeding, orofacial development and traditional bodywork therapy
Nine reasons why traditional bodywork therapy makes life with your baby harder than it needs to be