Unpopular opinions:

Families seeking help for their breastfeeding challenges are frequently told that their baby needs "bodywork". There is NO standard for what that entails or who should be providing the services. Families often seek out chiropractic services or an IBCLC who is also trained in craniosacral therapy. Both of these methods have their place, but these providers lack training in oral motor function that is integral in occupational therapy. There are four practices that are of particular concern to me:

1. Tummy time before the age of 4 months. Tummy time was developed as an answer to skull flattening that resulted from the "Back to Sleep" program introduced to prevent SIDS. Doing tummy time on your chest, particularly if is is skin to skin contact is indicated in the first few weeks of life. Classes in Tummy Time are being taught for infants as young as 3 weeks. Feeding is a function of full body flexion (think of the fetal position), not extension. The spinal extensors (back muscles) become overdeveloped with Tummy Time before it is developmentally appropriate. Of further concern is that the nerves that are the hard wired "alarm" system of the body are directly under the spinal extensors. Every time the baby arches their back, they activate the alarm system. What I see is a vicious cycle of arching, screaming, and "popping off" the breast. I have to "undo" the muscle imbalances created by this method and introduce techniques to activate deep muscle flexor stability and a functional suck.

2. Reflex integration: Babies are SUPPOSED to have reflexes. Practitioners seen on video jiggling babies or doing some sort of handling in order to "integrate" the reflexes. Infants do no yet have volitional (intentional movement). Not only is this practice unsound, it is performed by practitioners that are working outside their scope of practice. It is clear that the proponents of this method have no training in neurobiology, particularly function of the brainstem.

3. Intentionally suppressing an infant's gag reflex. Excessive gagging is a function of oral motor dysfunction. Once the functional pattern is established, the gagging resolves. Gagging is protective mechanism to prevent aspiration. Holding a baby's tongue down until he or she stops gagging takes away one of their most basic self protective mechanisms.

4. The "guppy" . I honestly don't know where this came from other than it is a baby "yoga" pose. The infant is placed on the lap of the provider and allowed to drape themselves backwards in the air. The baby's arms and head flail around and eventually "relax". (which to me looks like a "shut down" vs "relaxation"). I have read that this is to stretch the baby's neck. There is no foundation or justification for doing this. Elongating the throat muscles make is harder for the baby to suck. Babies need postural stability, and full body flexion in order to effectively breastfeed. Think of keeping them "collected" vs "stretched out.

5. I am not in support of the use of Oral Myofunctional Therapy. It's unintended consequence is Craniel base dysfunction. Look out for more information about upcoming webinars where I will expand upon this topic.

6. I am not in support of the Gilliespie Craniosacrial Myofascial method. The claims made by the founder are questionable, and it appears that. he is using the honorific "Dr" despite having an expired license. Further investigation will be forthcoming.