P3.Q327: Osteopathic Manipulative Medicine to support the Breastfeeding Dyad: a Scoping Review

Background: Breastfeeding is universally accepted as the first available and preferred choice of nutrition for infants. There are health benefits for breastfed infants and breastfeeding parents as well. Despite recommendations for exclusive breastfeeding in the first 6 months of life, a survey on breastfeeding rates showed only 26% of infants met this goal. There are many documented barriers to achieving this goal, including infant and parental factors. Osteopathic manipulative treatment (OMT) has shown benefit for infants with breastfeeding difficulties and other issues that may potentially influence the breastfeeding experience. OMT has also been used to help breastfeeding parents. Additionally, studies have demonstrated that OMT has a low risk profile & can safely be applied in these populations.

Methods: To provide a comprehensive picture of the role of OMT in breastfeeding medicine, a scoping review aimed to identify and present current peer-reviewed publications on the use of OMM for the breastfeeding dyad was conducted. The protocol was drafted using the Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) framework, and the final protocol was registered prospectively with the Open Science Framework. The data management tool selected for this scoping review was Covidence, where each title/abstract had 2 independent reviewers who determined inclusion/exclusion based on agreed upon criteria. Inclusion criteria included studies with a population of infants up to 24 months of age and/or breastfeeding parents of any age and search terms of conditions that may influence breastfeeding for the infant (e.g. torticollis and plagiocephaly) or breastfeeding parent (e.g. mastitis and low milk supply), respectively. Papers were excluded if they had interventions that were not OMT or OMTh (osteopathic manipulative therapy) or were not available in English.

Results: 3235 studies were identified following a search of seven databases. 2457 abstracts were screened following removal of duplicates. Approximately 150 studies made it to full text review, and are currently being reviewed. The majority of exclusions were either review papers or grey literature. All excluded reviews and consensus statements will be reviewed with a backward chain approach to assure a comprehensive final scoping review.

Conclusion: Given the safety profile, OMT may provide a unique modality to address some of the potential challenges the nursing dyad experience in their attempt to establish and sustain a breastfeeding relationship. There is a need for future ongoing high-quality and larger clinical trials to conclusively determine which problems OMT is best able to address.