Effects of Osteopathic Manipulative Treatment on Breastfeeding LATCH Assessments in Infants




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Importance: Effective suckling is crucial for infants to gain nutrition, grow, and bond with their mothers. Suckling difficulties within the first month can put infants at a higher risk of early weaning. Successful suckling involves coordinated movements of the lips, tongue, and jaw which rely on input from cranial nerves. Half of mothers who stop breastfeeding in the first month report biomechanical issues, highlighting the need to address these challenges for successful breastfeeding. Osteopathic Manipulative Treatments (OMT) have been utilized to treat the infant population for a variety of somatic dysfunctions and may be effective for suckling difficulties. Objective: To evaluate infants’ LATCH assessment scores before and after OMT sessions in the term infant population with feeding difficulties. Design, Settings, and Participants: This was a longitudinal prospective study conducted between October 2022 and July 2023 of 40 term infants <6 months of age with at least one of the following conditions: feeding difficulty, ankyloglossia (tongue tie), difficulty gaining and/or maintaining weight. After completing an initial eligibility screening, patients and their parents attended two clinic visits one week apart. Parents completed a LATCH questionnaire to evaluate infant latching at the beginning of each visit (visits 1-2). A phone follow up was conducted two weeks after the second visit to collect the LATCH survey over the phone (visit 3). Interventions: Participants received two full body OMT treatments one week apart, done by two different osteopathic physicians. Main Outcomes and Measures: LATCH assessment tool assigns a score of 0, 1, or 2 for five components (Latch, Audible swallowing, Type of nipple, Comfort, Hold) of feeding for a possible total score of 10 points, with higher scores indicating better outcomes. LATCH numerical scores were compared between the two visits to gauge improvement of the infant’s feeding abilities following OMT. LATCH scores were compared between the first and second visit, the second and third visit, and from visit 1 to visit 3 using independent samples t-tests. Results: Infants in the study were an average of 7.1 weeks old (standard deviation (SD)=4.4), an average weight of 3.6kg (SD=0.4) and an average length of 20.4 inches (SD=0.9). The majority were of white ethnicity (80%), possessed medical insurance coverage (92%), and had insurance covering lactation consultants (61%). Statistical analyses revealed a significant improvement in the LATCH scores between Visit 1 (8.01) and 2 (8.47; p=0.012); a significant improvement in LATCH scores between Visit 2 (8.47) and Visit 3 (9.11; p=.005); and an overall significant improvement from Visit 1 to Visit 3 (p<.001). The improvement at Visit 2 compared to Visit 1 was significantly larger among those who were bottle-fed (change=1.35) compared to those who were breastfed (change=0.21; p=.004). Conclusions and Relevance: In term infant populations with feeding difficulties, OMT significantly improved the LATCH scores over the course of the study. There are specific subpopulations, such as infants who were bottle-fed, who may have greater improvement in LATCH scores following OMT. OMT remains strongly recommended in this patient population to help with difficulties pertaining to latching.