Infant Somatic Dysfunction and Breastfeeding LATCH Assessments following Osteopathic Manipulative Treatment

Purpose

Importance: Breastmilk is known to be beneficial for newborns but challenges with latching can provide a significant barrier for breastfeeding. Such challenges may possibly stem from biomechanical and neurological restrictions inhibiting proper latching and sucking in infants. Osteopathic Manipulative Treatment (OMT) may address somatic dysfunctions associated with these restrictions and improve breastfeeding outcomes.

Objective: To evaluate changes in infant somatic dysfunctions after a single OMT treatment and assess correlation with changes in latching using the LATCH assessment tool.

Methods

OMT was performed on 40 participants seen at the For Babies’ Sake clinic in Fort Worth, Texas between October 2022-July 2023. Eligible patients under 6 months old met at least one of the following criteria: feeding difficulty, ankyloglossia, or difficulty maintaining weight. Exclusion criteria included neurologic conditions, cleft lip or palate, lingual frenectomy within 72 hours of visit, hospital admission, and any conditions in which OMT would be contraindicated.

Intervention: During two visits 1 week apart, an Osteopathic physician assessed participants’ somatic dysfunctions in the following regions: OA/condyles, occiput and OM, frontal bones, nasion, maxilla/premaxilla, zygomas/TMJ/temporals, tongue/pterygoids, anterior cervical muscles/hyoid, trunk/viscera, ribs/mediastinum, sacrum, pelvis, hips, knees, and navicular regions. Somatic dysfunctions were rated as 0=no somatic dysfunction, 1=mild, 2=moderate, 3=severe, marked or resistant. Somatic dysfunctions were addressed with treatments including: myofascial release, balanced ligamentous tension, balanced membranous tension, osteopathic cranial manipulative medicine, or vibratory treatment by percussion hammer. Parents completed a standardized LATCH assessment during visits 1 and 2, and responded to a LATCH questionnaire after visit 2. The LATCH questionnaire was shown to be a validated measure of latch, audible swallowing, nipple type, comfort, and hold and results in scores of 0-10, with higher scores indicating better breastfeeding outcomes.

Main Outcomes and Measures: Rated somatic dysfunctions were compared between visit 1 and 2 to assess for statistically significant improvement. Changes in somatic dysfunction and LATCH scores were also assessed for correlation using t-tests.

Results

Mean age was 7.14 weeks (standard deviation=4.44). The following regions showed significant reduction in somatic dysfunction (p<.05) from visits 1 to 2, with mean change values shown here: OA/Condyles: -.75, Tongue/Pterygoids: -0.58, Trunk/viscera: -0.50, and Navicular: -0.38. The mean sum of all somatic dysfunctions was also significantly reduced by 4.15 between visit 1 and 2 (p<.01). The sacrum region was related to LATCH score change, with lower sacrum improvement across visits negatively correlated to more improvement LATCH scores from visits 1-3 (p<.01) and visits 2-3 (p<.05).

Conclusions

These results suggest that a single osteopathic treatment may reduce somatic dysfunction in newborns in multiple body regions. The connection of somatic dysfunctions and LATCH scores needs further research. Though helpful for assessing latch quality, the LATCH assessment does not assess actual infant milk intake or weight gain. Future studies could compare weight gain between OMT treated infants and a control group. It would also be beneficial to replicate this study with additional Osteopathic physicians to determine if improved somatic dysfunction results are repeatable between physicians.