The effectiveness of the laid-back position on lactation-related nipple problems and comfort: a meta-analysis

Abstract

Background The importance of breastfeeding for maternal and child health is agreed upon worldwide. However, lactation-related nipple problems are common and are important factors affecting breastfeeding. Multiple studies recommended laid-back breastfeeding, but they are of various levels of quality, and the results are inconclusive. Methods We systematically searched the following twelve databases from inception to January 28,2020: Cochrane Library, EMBASE, Medline, Ovid, PubMed, Web of Science, CINAHL, Scopus, Chinese National Knowledge Infrastructure (CNKI), China Biology Medicine disc (CBM), WanFang, and VIP. All studies regarding laid-back breastfeeding or biological nurturing were considered, regardless of whether they were randomized controlled trials. Two trained investigators independently evaluated the quality of the selected articles and screened the data. All the data were analysed separately using Review Manager Version 5.3 and STATA/SE Version 15.1. Results A total of 12 studies involving 1936 groups of postpartum women and their newborns were included. The results of the meta-analysis showed that nipple pain (RR = 0.24; 95% CI 0.14, 0.40; p < 0.00001), nipple trauma (RR = 0.47; 95% CI 0.29, 0.75; p = 0.002) and correct latching position (RR = 1.22; 95% CI 1.11, 1.33; p < 0.0001) in the experimental groups were all better than those of the control groups, and the differences were statistically significant (p < 0.05), which indicates that the laid-back position has a positive effect on maternal breastfeeding. However, the results of position comfort showed that there was no statistical significance between the two groups (ES = 0.09; 95% CI -0.63, 0.81; p = 0.798). Conclusion Compared with traditional breastfeeding positions, the laid-back position has been proven to be related to a decreased incidence of nipple pain and nipple trauma and is seemingly conducive to the use of the correct latching position. It is suggested that the laid-back position is helpful in solving lactation-related nipple problems and can be recommended as a position for breastfeeding. However, no significant difference in position comfort was found between the two groups based on the current evidence, and further studies are still needed to validate these results due to the limitations of the included studies.

A brief gestalt intervention changes ultrasound measures of tongue movement during breastfeeding: case series

“…A 2020 meta-analysis which searched the literature for the benefits of ‘laid-back breastfeeding’ or ‘biological nurturing’ selected 12 studies, 11 randomised controlled trials (RCTs) and 1 quasi-randomised controlled trial. This meta-analysis found that when the biological nurturing approach is applied in the first three days post-birth, at follow-up after a period of between 3 days to 8 weeks there was a significant reduction in nipple pain and nipple trauma, though no difference in position comfort [ 24 ]. 11 of these studies were published in Chinese.…”

“…Therefore, a gestalt clinical intervention aims to stabilise the fit between the infant and his or her mother’s body and breast, which eliminates breast tissue drag. The gestalt method builds on the foundations of ‘laid-back breastfeeding’ positioning [ 24 ], but integrates a range of other strategies to optimise suckling biomechanics (See ‘Key elements of the gestalt approach to clinical breastfeeding support’, Additional file 1 ). This approach has implications for multiple aspects of usual lactation support, including for minimising unnecessary pharmaceutical, surgical and bodywork interventions [ 35 ].…”

Comparison of L-Shape and Side-Lying Positions on Breastfeeding Outcomes among Mothers Delivered by Cesarean Section: A Randomized Clinical Trial

“…Contrary to the present findings, studiesshowed a statistically significant difference in satisfaction scores in the side-lying group compared to the laid-back group. 13 , 25 Therefore, keeping the primary and secondary objectives of the current study in mind, it can be said that side-lying and “L” shape were equally effective in providing breastfeeding outcomes and maternal satisfaction, but significant difference was evident in maternal pain as post-cesarean mothers felt less pain in “L” shape position compared to a side-lying position. The researchers were unable to conduct the study in more than one setting to increase generalizability.…”

Prevalence of breastfeeding in a baby-friendly pediatric practice in Trieste, Italy: follow up to 36 months of age

“…First, when professional and peer support is provided, breastfeeding rates increase [ 14 ]. Second, biological nurturing and the laid-back position reduce breast problems [ 15 , 16 ], and can thus promote a better establishment and continuation of breastfeeding. As secular trends are unlikely to explain our results, the most likely explanation for our high breastfeeding rates is the application of our composite intervention.…”