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When it’s not about Ankyloglossia: A case of Osteopathic Manipulative Treatment for Newborn Breastfeeding Difficulties in the Absence of Restricted Labial or Lingual Frenula

Journal: The AAO Journal Date: 2025/06, 35(2):Pages: 20. doi: Subito , type of study: case report

Full text    (https://aaoj.kglmeridian.com/view/journals/aaoj/35/2/article-p13.xml)

Keywords:

breastfeeding [32]
case report [705]
newborn [73]
OMT [3746]
osteopathic manipulative treatment [3766]
pediatrics [527]

Abstract:

Introduction: Breastfeeding difficulties in newborns can significantly affect both the infant and the mother by leading to ineffective latch and milk transfer. While restricted labial frenulum and ankyloglossia are frequently considered factors associated with breastfeeding difficulties, cranial and musculoskeletal dysfunctions may also contribute. Osteopathic manipulative therapy (OMT) has been proposed as an effective treatment for addressing these issues by improving structural alignment and offers a non-invasive treatment to address these challenges. Case: A 5-day-old otherwise healthy newborn presented with breastfeeding difficulties characterized by a painful latch reported as 7/10 in severity by the mother. The infant was born at 39 weeks gestation after 33 hours of labor and an uncomplicated delivery. Physical examination demonstrated a shallow latch and recessed mandible with full tongue range of motion. Osteopathic structural exam revealed hypertonic lateral pterygoid muscles, overriding coronal suture, internally rotated right parietal bone, and multiple axial spine somatic dysfunctions. OMT using direct and indirect techniques addressed the various structural findings. Results: Following two OMT treatments, the pain associated with the infant's latch reduced to 3/10 severity. Physical exam showed improvements such as increased bottom lip and jaw protrusion during breastfeeding, a reduction in mandible recession, improved weight gain and correction of the overriding coronal suture. Discussion: Targeting specific cranial and musculoskeletal dysfunctions with OMT significantly improved mandibular dynamics and latch. This case highlights the role of OMT when treating breastfeeding difficulties in the absence of typical structural issues like labial frenulum restriction or ankyloglossia. Limitations of this study include lack of generalizability and absence of control group. This case supports the integration of OMT by offering a noninvasive alternative for managing newborn breastfeeding difficulties.


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