The Occupational Therapist’s role on your infant feeding team.

Q: Why bring a lactation-informed occupational therapist (OT) onto the feeding team if I am already seeing a lactation provider?

Integrating a lactation-informed occupational therapist (OT) into the feeding team, alongside an existing lactation provider, can offer a comprehensive and holistic approach to support your baby. Here are some key reasons for this collaboration:

1. Multi-disciplinary Expertise: A lactation-informed OT and a lactation provider bring different areas of expertise to the table. IBCLCs are the gold standard as it relates to supporting the infant feeding dyad. While IBCLCs and OTs have unique and sometimes overlapping skills depending on their training and experience when assessing and treating feeding challenges, often times, IBCLCs and OTs work closely together as a team for best outcomes.

   Occupational therapists have a unique lens considering relational and environmental factors as well as how physical, mental, emotional and sensory components impact function and engagement in daily activities. Occupational therapists are skilled at promoting optimal function through meaningful and motivating play and activities. This combined knowledge can lead to a more thorough evaluation and treatment plan to address breast or bottle feeding difficulties.

2. Whole-Child Assessment: An OT is trained to evaluate a child's overall development, including motor skills, sensory processing, and oral function. This perspective allows for a comprehensive understanding of the infant's feeding challenges. An occupational therapist trained in infant feeding and TOTs (tethered oral tissues) is highly skilled at assessing and supporting the following:

   • Primitive reflexes and active movements involved during latching and feeding

   • Nervous system functioning and regulation

   • Cranial nerve functioning

   • Mobility & whole body tension

   • Postural asymmetries impacting feeding

   • Social engagement

   • Visual motor skills

   • Airway & respiration

   • Oral rest posture

   • Oral-facial structures

   • Whole body strength and endurance for feeding

   • Development and motor milestones

   • Oral motor function including oral reflexes, tongue strength, endurance, coordination, and range of motion

   • Suck-swallow-breath coordination 

   • Sensory processing impacting regulation, sleep and movement

   • Family and environmental factors

     Occupational therapists look closely at functional feeding and whole body considerations that may be impacting efficiency and comfort during feeds, for both the baby and parent/caregiver. 

3. Customized Intervention Plans: Collaborative efforts between a lactation provider and a lactation-informed OT enable the development of tailored intervention plans. This can include strategies to optimize latch, position, and overall feeding mechanics, as well as taking into account any underlying sensory or motor difficulties that may be contributing to feeding difficulties.

4. Early Intervention & Foundational Roots for Development: Feeding is a vital sign and a fundamental movement milestone. Bringing an occupational therapy provider on board provides an essential opportunity to identify and address potential sensory processing or motor difficulties that may impact feeding and your child's development. A lactation-informed OT can provide strategies to support the infant's foundational skills, ensuring that feeding experiences contribute positively to overall development. Identifying and addressing feeding and movement challenges early on can have a positive impact on the infant's growth, development, and overall well-being. By involving an OT on the feeding team, potential developmental delays or issues can be identified and addressed promptly, leading to improved feeding experiences and supports overall health and well-being.

5. Holistic Care: Ensuring that both the lactation provider and OT are on the same team fosters a collaborative, family-centered approach to care. This ensures that all aspects of feeding are considered in the treatment plan.

6. Ongoing Support: Working together, the lactation provider and lactation-informed OT can provide continuous support and guidance to your family. This includes monitoring progress, making necessary adjustments to the intervention plan, and addressing any emerging concerns related to infant feeding, including supporting success with later feeding milestones, such as the progression to solid foods, straw and open cup drinking and any related movement, oral motor or sensory concerns impacting this transition.

In summary, including a lactation-informed OT on the feeding team alongside a lactation provider may enhance the depth of expertise available to your family to support feeding goals. This collaborative approach allows for a comprehensive assessment and intervention plan, ultimately leading to improved feeding outcomes for both baby and your family as your baby develops.

It doesn’t stop here! Depending on the provider’s training and expertise, as well as your baby’s unique and individual needs, other team members may be recommended to support your feeding goals. These providers may include, but are not limited to:

• physical therapist

• speech therapist

• osteopath

• chiropractor

• craniosacral therapist

• pediatric dentist

• registered dietician

• functional medicine provider

• ENT or other medical provider

• primary care physician

If you have questions or concerns regarding your baby’s feeding or development, don’t hesitate to reach out!

- Carmen Smith OTD, OTR/L