Breastfeeding when there are special needs
Feeding therapists offer specialized care
Written by Carol Anne Hamilton-Dodd, MA, OTR/L, CLEC (IBCLC certification in process)
Advanced Clinical Specialist, Spaulding Outpatient Center Foxborough
Breastmilk is the best source of nutrition for babies, according to the American Academy of Pediatrics and the World Health Organization. Both organizations recommend breastmilk exclusively for the baby’s first 6 months and — in combination with solid foods — until 12 months.
The benefits of breastmilk to babies are well documented, such as supporting infant gut health, fewer infections, and lower risk of obesity, as well as additional physical benefits.
In addition, there are benefits to the lactating parent’s health. Successful breastfeeding is dependent on both parent and baby, known as the “dyad.” When breastfeeding or breastmilk may not be an option or choice, there are alternative sources to feed your baby.
Prenatal, perinatal, and postnatal education supports the lactating parent’s goal to breastfeed and/or provide breastmilk. There are a variety of health care providers with specialized training to support breastfeeding. A parent with complications and/or a baby with special needs may require additional supports to meet their lactation goals or to make modifications to their plan.
A feeding therapist, typically an occupational therapist or speech language pathologist, as part of the feeding team, can support the breastfeeding dyad that may be facing feeding challenges related to a baby’s medical needs, such as motor, sensory, neurological, developmental, oral, and swallowing function. Understanding the complexity of breastfeeding and providing support often requires a team with specialized training in pediatric feeding and breastfeeding/chest feeding difficulties. Support of both the lactating parent and the baby’s needs are important for success.
Feeding specialists evaluate, treat, and provide guidance when a baby is having difficulty with:
- Weight gain and meeting nutritional needs
- Latch and positioning
- Successful milk transfer
- Oral motor and swallowing function
- Feeding related avoidance and struggles
- Other factors that interfere with positive and successful feeding experiences
Considerations for parents:
- Discuss feeding goals and preferences with your medical team and support person(s).This may be your spouse/partner, family, friends, obstetrician, midwife, doula, pediatrician, and any other provider that may be part of the team that is able to provide evidenced-based support.
- Breastfeeding is a skill that may require patience, time, resources, and support. Both the lactating parent and baby are learning new skills. Each baby has their own unique needs and feeding requirements. Some dyads are quickly successful, while others need more strategies and time.
- There are a variety of resources both in the community and online to support your choices in feeding your baby, whether it is feeding at the breast, pumping, using a bottle, supplementing with alternative approved formulas, or a combination. A feeding therapist with specialized training can help support your goals.
- NOTE: We do not recommend home-made formulas, as they can be detrimental to the health of your baby. Speak with your medical care providers for clarification.
- Mass General Brigham Hospital Network and Spaulding Rehabilitation Hospital Network offer a variety of support services and clinics. Speak with your medical provider(s) for specifics.
- Massachusetts Lactation Consultant Association
- International Board Certified Lactation Consultants is a public registry to locate a specialist
- American Academy of Pediatrics position on breastfeeding
- Center for Disease Control information on breastfeeding
- World Health Organization position on breastfeeding
- Occupational therapy role and breastfeeding promotion: Our role in societal health
Am J Occup Ther. May-Jun 2014;68(3):e90-6. doi:10.5014/ajot.2014.009746.
Research Article Issue Date: May/June 2014 Published Online: May 01, 2014 Updated: April 30, 2020
For more information or to be scheduled for a feeding and swallowing evaluation,
please contact a Spaulding Pediatric Outpatient site.