Breastfeeding and Posture & Pelvis the ups and downs!

New mums have expectations of the joy of breast feeding, aiming to bond with their new baby and provide the best nourishment on the planet however…

Breastfeeding in the early days can be a stressful time and doesn’t always come easily. It is also something you will spend a large amount of your day doing, so it is important to maintain a good posture for both you and the baby. What’s more, hormonal changes in pregnancy can loosen the joints and the ligaments that attach your pelvic bones to your spine, which can make you less stable and cause pain during pregnancy.

These changes don’t go away overnight. So you need to be careful in this post partum period to protect your back until your muscles regain their strength and your joints become less lax.

An ideal sitting position for feeding involves:

  • bottom back in the chair
  • distribute body weight evenly between the hips
  • knees bent at 90 degrees and feet flat on the floor or a foot stool
  • arms supported by pillows so that shoulders are relaxed

By maintaining good posture you also allow for the breast to be positioned straight, making it easier for the baby to attach and feed. A good attachment helps with prevention of mastitis.


Mastitis is a condition where the breast tissue becomes inflamed; this may or may not be in association with an infection. Mastitis is usually the result of a blocked milk duct that hasn’t cleared. Some of the milk banked up behind the blocked duct can be forced into nearby breast tissue, causing the tissue to become inflamed.

Early symptoms of mastitis can make you feel as if you are getting the flu. You may begin to get shivers and aches. The breast will be sore like it is with a blocked duct, only worse. It is usually red and swollen, hot and painful. The skin may be shiny and there may be red streaks.

The best treatment for mastitis is to drain the breast often, but gently. Let the babies chin direct the drainage of the breast, position the baby so their chin “points” to the area of hardness. Vary the baby’s position on the breast so that all ducts are emptied. Mastitis is most common in the upper outer quadrant of the breast as we don’t tend to position to drain that area. Examples of some safe breastfeeding positions are shown below.


In some cases it may also be helpful to express by hand or pump depending on pain. Using hot and cold packs can also be helpful. A hot pack is best used just before feeding to help aid with the let-down reflex and cold backs after feeding to reduce pain and swelling.

Physiotherapists can help with massage through the blockage and use of therapeutic ultrasound to provide faster relief.

It is important to note that if you are also suffering from a fever contact your GP or maternity unit as you may require antibiotics.

Tips to help prevent Mastitis:

1) Choose a comfortable chair with armrests. Bring the baby up to the nipple and use pillows for extra support for your back and arms. This should ensure that your baby is attached and feeding well.

2) Avoid missing feeds and if the breast becomes uncomfortably full, wake your baby for a feed. If your baby is not interested in feeding, you may want to express a small amount.

3) Alternate from which breast you begin each feed. This should ensure over the course of a day that both breasts get evenly drained

4) Change feeding positions regularly. Try to choose positions that allow the milk to flow downhill to your baby. Let your baby’s chin direct the drainage from the breast.

If you have any questions or if you would like to book an appointment to see one of our Physios, please call 9971 2185.


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