Neck Pain and Nursing (and Bottle-Feeding and Spoon-Feeding!)

By Diana Brooks, PT, DPT
Tidewater Physical Therapy, Inc.
Ironbridge Clinic

I see many new moms in my office with complaints of neck and upper back pain.  The obvious reason is carrying around that newborn bundle of joy!  Most of us will constantly carry that ever-growing bundle around in the same arm out of habit or just because one arm is stronger than the other.  Why does this contribute to neck pain?  Think about how you would carry around a 10 pound weight.  You’d probably carry it using one arm with that arm hanging down by your side.  The muscles that attach to your shoulder blades would have to work harder to keep your arm from drooping down on that side.  

Those same muscles also attach to your neck.  

When you are holding, carrying, nursing, or bottle-feeding your baby, you are maintaining what’s called a static contraction of those muscles.  A static muscle contraction causes decreased blood flow to the muscle.  At the same time, the normal waste products from metabolism are not being carried away leading to fatigue, soreness and injury. 

Combined all of this with the constant pulling of a muscle on the bone it attaches to (in this case, the vertebrae in the neck) and those bones can be pulled out of proper alignment over time.

Here are some examples of common feeding positions with guides on how to improve your posture to minimize static muscle contractions.


boppy TPTIAt 5’8”, I’m only slightly taller than the average woman.  I found with using a nursing pillow and the “football” or “cradle” holds, that the baby was still so low on my chest I had to twist awkwardly for her to latch on.  You can try boosting your baby up with an extra pillow under the nursing pillow, but then you have to have two pillows every time you nurse. 

Notice how far I’m leaning to the side and forward to get into position.  Holding this angle through the head and neck for a prolonged period puts added stress on these muscle groups.  I found the extra pillows and leaning forward still doesn’t get my baby close enough, so I’m manually holding her up to the proper height.  From this position, my biceps, trapezius and spinal muscles are all firing to maintain this hold.  In babies’ first days, nursing sessions frequently last 30 minutes and are happening 8-12 times a day for up to 4-6 hours of static muscle contractions.  

The wonderful lactation consultants I saw at the hospital introduced me to the “biological” or upright nursing position.  There are many benefits of this position besides feeding the baby from an upright, symmetrical posture.  This is a great position to promote skin-to-skin contact in the early days, which is shown to help baby regulate body temperature.  I found I had less soreness and less difficulty with the baby latching on in this position.  My daughter is 6 months old in this picture and now rests easily on my thigh.  When she was smaller, I would lean farther back and let gravity hold her onto my chest.  Even within a few hours of birth, she was able to bob her head around and get herself into position.

Bottle Feeding

I liked the nursing pillow better for bottle feeding than nursing!  It helps to bring the baby up to you so she is resting on the pillow and not being held up by your arm.  Notice how level the shoulders are in this position.   Using pillows under your arms so that your muscles are relatively inactive during this activity.  This will help minimize strain of the shoulder and spinal musculature.

Spoon Feeding

It’s a little harder to master a symmetrical spinal posture when your child begins eating solid foods, largely due to handedness and working around the high chair.  Here my baby is positioned a little too far away from the high chair so that when feeding, the right arm is elevated and your trunk is twisted in order to reach the baby.  Try positioning yourself closer to the high chair and if possible, adjust its height so that the baby is sitting closer to your shoulder height.

Just remember to be comfortable no matter how you are feeding baby!  The key to preventing injury is to minimize asymmetrical postures which decreases muscle strain.  See a lactation consultant if you continue to have difficulty with nursing positions.  If you have a neck or back issue that doesn’t resolve with improving posture, then make an appointment to see your physical therapist

More great information from Tidewater Physical Therapy:
Rebuilding Core Strength After Pregnancy
Pain in Pregnancy: Common, Not Normal

Diana Brooks, PT, DPT earned her Bachelor of Science with a concentration in Sports Medicine from the University of Virginia, and her Doctorate of Physical Therapy from the Medical College of Virginia.
Make an appointment with Diana at the Iron Bridge Location.


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