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K. Takeda1, M. Miyashita2, E. Nabekura3, T. Himi3, M. Imura4
1Tokyo International University, Health Care School of Health Sciences, Kawagoe, Japan, 2Miyashita Maternity Hospital, Yokohama, Japan, 3Oketani Lactation Society, Tokyo, Japan, 4Japanese Red Cross College of Nursing, Graduate School of Nursing, International Health Care and Midwifery, Tokyo, Japan
Background: Breastfeeding posture depends on the positional relationship between the mother and the infant and is affected by gravity.
Purpose: The purpose of this study was to clarify the breastfeeding posture that is more effective and reduces the physical burden on the mother, by analyzing the mother's muscle activity and perceived strength during breastfeeding.
Methods: The study subjects were 20 pairs of mothers who gave consent for participation in the study and their children who were stably breastfed at a breastfeeding consultation facility. The mothers were in their 20s to 40s, and their infants ranged in age from 1 to 5 months. The measurement task consisted of feeding-side movements at each of three trunk angles (seated trunk with 10° forward bending, seated trunk in the vertical position, and seated trunk with 45° backward bending). The measurement items were
(1) upper limb electromyography (bilateral trapezius, biceps brachii, and feeding-side flexor carpi ulnaris) and
(2) subjective strength using a modified Borg scale during breastfeeding.
A Delsys Trigno Wireless System (Delsys Inc., Natick, MA, USA) was used as the myoelectric measurement device. Breastfeeding measurements were performed with the mother-child pair in a separate room from the person performing the measurements, with the assistance of a midwife for adjusting the measurement signals and setting the angle of the reclining chair. Electromyography measurements were performed for 30 seconds under each condition, and each trunk angle condition was measured twice. Statistical comparisons were performed by the Dunn-Bonferroni method after a Kruskal-Wallis test using IBM SPSS Statistics for % Electromyography of each muscle at each trunk angle condition (p<0.05).
(1) upper limb electromyography (bilateral trapezius, biceps brachii, and feeding-side flexor carpi ulnaris) and
(2) subjective strength using a modified Borg scale during breastfeeding.
A Delsys Trigno Wireless System (Delsys Inc., Natick, MA, USA) was used as the myoelectric measurement device. Breastfeeding measurements were performed with the mother-child pair in a separate room from the person performing the measurements, with the assistance of a midwife for adjusting the measurement signals and setting the angle of the reclining chair. Electromyography measurements were performed for 30 seconds under each condition, and each trunk angle condition was measured twice. Statistical comparisons were performed by the Dunn-Bonferroni method after a Kruskal-Wallis test using IBM SPSS Statistics for % Electromyography of each muscle at each trunk angle condition (p<0.05).
Results: The study participants were 20 mothers (age 35±4.4 years, height 160.1±5.3 cm, weight 53.3±6.6 kg) and 20 infants (age 2.3±1.4 months, weight 5715.3±1192.3 g). Comparing muscle activity in the three trunk angle conditions, there was a significant decrease for both trapezius and flexor carpi ulnaris muscles with 45° backward flexion of the trunk in back-rested sitting (trapezius P=0.003,forward bending 15.6±12.1%,vertical 15.9±12.4%, backward bending 5.2±2.5%: feeding-side trapezius P=0.004, forward bending 19.9±18.3%, vertical 16.4±14.2%, backward bending 6.4±5.5%:feeding-side flexor carpi ulnaris P=0.001, forward bending 17.6±12.4%, vertical 13.1±10.4%, backward bending 6.4±5.5%, p < 0.05). On the modified Borg Scale, mothers felt a somewhat stronger physical burden when breastfeeding in forward bending than when breastfeeding in other positions (Median: forward bending 4, vertical 3, backward bending 2).
Conclusions: Breastfeeding in the sitting position has a greater impact on the mother’s body as the baby gains weight, and might cause pain, such as stiff shoulders and tenosynovitis. Our results suggest that mothers should breastfeed their infants in the reclining sitting position, which decreases the effects of gravity on the arm girdle supporting the infant, so that tightness of the trapezius muscle and the forearm muscle group is reduced.
Implications: Physiotherapy intervention for physical dysfunction during child-rearing promotes stability in child-rearing.
Funding acknowledgements: This research was conducted with the aid of a MEXT 2019 research grant (#19K11079).
Keywords:
Breastfeeding
Electromyogram
Muscle fatigue pain
Breastfeeding
Electromyogram
Muscle fatigue pain
Topics:
Pelvic, sexual and reproductive health
Health promotion & wellbeing/healthy ageing/physical activity
Pelvic, sexual and reproductive health
Health promotion & wellbeing/healthy ageing/physical activity
Did this work require ethics approval? Yes
Institution: Tokyo International University
Committee: The Approval of the Ethics Committee at Tokyo International University
Ethics number: 45281
All authors, affiliations and abstracts have been published as submitted.
