Breastfeeding and Postpartum Recovery: A Women’s Health Physio’s Guide by Kathryn Melvin Women's Health APA Physiotherapist

Breastfeeding is a deeply personal journey, one that intertwines physical recovery, hormonal shifts, and postural demands. As a women’s health physiotherapist, understanding these dynamics can empower new mothers to navigate breastfeeding while protecting their bodies from unnecessary strain or injury.

The Physical Demands of Breastfeeding

While often portrayed as a natural and effortless experience, breastfeeding requires endurance, flexibility, and muscular engagement. Holding a baby for extended periods, maintaining fixed postures, and adjusting to latch requirements all create physical stress.

Common breastfeeding-related injuries include:

  • Neck & Shoulder Pain: Repetitive forward-leaning postures may lead to tightness and discomfort.

  • Wrist & Thumb Pain (De Quervain’s Tenosynovitis): Supporting the baby’s head with the hands, especially with poor wrist positioning, can aggravate this condition.

  • Pelvic Floor Sensitivity: If perineal tears or episiotomy occurred during birth, certain breastfeeding positions may exacerbate discomfort.

Hormonal Impacts on Recovery

Breastfeeding influences hormonal levels, which can affect muscle tone, joint integrity, and overall recovery.

  • Relaxin: Although levels drop post-birth, breastfeeding may prolong its presence, affecting ligament laxity and joint stability.

  • Oxytocin: This hormone aids milk letdown but also impacts uterine contractions, facilitating postpartum healing.

  • Estrogen & Prolactin: Lower estrogen levels in breastfeeding mothers can contribute to vaginal dryness, which may affect comfort in seated positions. Lower Estrogen Levels also has an impact on tendons and joints, which may contribute to pain and/ or injury.

Optimising Feeding Positions for Recovery

Selecting an appropriate breastfeeding position can alleviate discomfort and support postpartum healing.

  • Reclined Sitting (Laid-Back Nursing)

Ideal for mothers recovering from perineal trauma or C-section, this position allows gravity to assist with latching while minimizing pelvic floor pressure.

  • Side-Lying Position

Great for nighttime feeds, side-lying reduces pressure on abdominal and pelvic areas while allowing for better relaxation during feeds.

  • Cross-Cradle & Football Hold

Both styles provide structured support but may lead to wrist and shoulder discomfort if posture isn’t adjusted periodically.

Physiotherapy Tips for Breastfeeding Comfort

1. Use Supportive Pillows: Placing pillows under the baby or behind your back can reduce strain.

2. Perform Gentle Stretches: Neck, shoulder, and wrist exercises can ease tension from prolonged feeding postures.

3. Engage Core & Pelvic Floor Muscles: Light activation of deep core muscles may assist with postural control.

4. Alternate Positions: Switching between different holds throughout the day prevents repetitive strain injuries.

Breastfeeding is not only an act of nourishment but also an opportunity for healing and physical awareness. By integrating physiotherapy principles, new mothers can optimise their experience while safeguarding their postpartum recovery.

References:

BMC Pregnancy and Childbirth 2024, Comparison of Postnatal Care Guidelines, BMC Pregnancy and Childbirth, available online: (https://bmcpregnancychildbirth.biomedcentral.com/articles/10.1186/s12884-024-06295-4) .

AUSactive 2023, Pregnancy & Postnatal Exercise Guidelines* , AUSactive, viewed 19 May 2025 <https://ausactive.org.au/wp-content/uploads/2023/03/AUSactive-Pregnancy_ Post-Natal-Exercise-Guidelines-FINAL-v2.pdf> – Covers physiotherapy considerations for postpartum recovery, including musculoskeletal health and exercise recommendations.

Northern Sydney Local Health District 2024, Postnatal Physiotherapy Information Booklet*, NSW Health, viewed 19 May 2025, <https://www.nslhd.health.nsw.gov.au/Services/Documents/QR/RNS/RNSPostnatalPhysiotherapyBooklet.pdf> – Provides physiotherapy guidance for postpartum recovery, including hormonal impacts and musculoskeletal health.

Brighten, J 2023, Balancing Hormones While Breastfeeding, Dr. Jolene Brighten, viewed 19 May 2025,<https://drbrighten.com/balance-hormones-while-breastfeeding/>

Stuart McKayComment