Pamela,

I contacted my sister who is a physical therapist.  While her specialty
is adult rehab, she had some thoughts about PT's working with
breastfeeding babies.

Her first suggestion was to look at the NICU/ward feeding schedules when
determining best times for working with the baby--before or after
feeding.  The baby may be more alert before a feed, but more unhappy.
After a feeding, s/he may be content but asleep. A sleeping baby may be
an advantage when manipulating little limbs, but they may need the baby
to be awake to make accurate judgements.

Also consider whether the PT's will be working with the mothers and
teaching them how to do the baby's exercises or whatever.  If they need
the mom, they should show up at feeding time because she will be there.
But, mom may be too overwhelmed with learning to breastfeed and may not
be able to cope with the PT showing up just as she has settled down with
the baby at breast.  She will need to concentrate on one activity at a
time.  Learn to breastfeed first while the PT does her work at another
time. When the feeding is going well, mom may be more receptive to
learning about exercises.  Perhaps a suggestion to the PT's that
breastfed babies probably will not be on a strict schedule so they will
need to be flexible.

My sister also suggested that you not focus too much on normal
situations as they see alot of developmentally delayed children, FTT and
those not getting enough physical stimulation.  With the
under-stimulated babies they would go in and play hard with them!
Of course, there will also be older babies who have been injured, but
she was thinking mostly about ill/delayed children.

She suggested that you address exercise restrictions for breastfeeding
mothers.  I hestitate to use the word "restriction" but mention of lots
of upper arm movement potentially leading to plugged ducts, etc might be
useful.  If a breastfeeding mother needs back therapy, she won't want to
spend lots of time lying on her stomach for therapy.

Her last suggestion was to contact your national PT professional
organization (APTA in the USA) for ideas, specifically their peds or
women's health sections.

Hope this helps.  Contact me privately if you would like her email
address for specific questions (or I can pass them along to her).

Kathy Koch, LLL Leader, AAPL
Alexandria, VA
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