Extrapolating the benefits of traditional bodywork therapy back to breastfeeding babies isn't consistent with evolutionary and neurodevelopmental science nor with breastfeeding as a global health priority
Busting myths about traditional bodywork therapy for infants #1. Approaches which show good outcomes for adults and children can't be extrapolated back and assumed to apply to babies
By the time we develop musculoskeletal problems in adulthood, we have had years or decades of dysfunctional movement patterns, developing low-grade tissue inflammation, fascial contractions, subtle (or severe) joint misalignments, and muscle knots. But traditional bodywork takes important principles which are relevant to an older child, adolescent or adult body, and extrapolates these principles back to the body of a baby, who is freshly out of the womb and in a unique phase of brain, body and tissue development.
It's often been the case over my professional life-time that interventions which are appropriate for older children or adults are extrapolated back and applied to infancy, without regard for the unique developmental needs and biology of a baby in the first year of life.
This extrapolating back from scientific discoveries which are helpful in later childhood and adulthood to infancy is a main reason why there has been so much overdiagnosis and overtreatment of babies who are unsettled or who have breastfeeding problems over the past few decades.
What does evolutionary biology tell us?
The human infant is born an 'exterogestate foetus', best understood physiologically in the context of the loving maternal or carer's body. The Homo sapiens infant in the first year of life is most effectively treated as a physiological extension of the maternal body.
You can find out about the single biological system of the breastfeeding mother and baby here.
Busting myths about traditional bodywork therapy for infants #2. Infant connective tissues aren't vulnerable to stuckness, joint compression, and inflammation in the same way as adult tissues
Traditional bodywork therapists identify a wide range of pathology in breastfeeding babies. It's suggested that these pathologies are not identified by the medical system because doctors are blind to subtle functional nervous system health.
I acknowledge that my own profession has a history of poor understanding of the subtleties of musculoskeletal function and implications for health. You can find out about this here.
What does evolutionary biology tell us?
Dysfunctions and fascial contractions build up in the human body over time, after months and years of dysfunctional or asymmetric movement patterns.
Homo sapiens infant fascia is not characterised by the kind of stuckness and tight contractility that we see in adult fascia.
A baby is born with connective tissues and fascia that is supple, adaptive, stretchy, pristine. Infant tissue is not prone to the same muscle knotting or fascia stickiness that we find emerging in older children and adults. Our newborns and babies have fresh tissues, unwritten upon, easily reconfigured by the constant return to the maternal body, activation of reflexes in the context of the parental body, and joyful engagement in rich environment experiences and interactions.
There is no reason to be manually stretching infant connective tissue, as stretching won't change what is already fresh and healthy tissue.
Busting myths about traditional bodywork for infants #3. Infant suck and tongue movement don't have fixed action patterns which go wrong and take weeks of manual therapy to re-wire or reset
Infant muscles can develop asymmetric movement patterns, whether due to (usually minor) tissue damage or influences in the environment (e.g. baby lying on her back looking towards the door for long periods). These asymmetric movements patterns are, for example, associated with deformational plagiocephaly, in a cascade of neuromuscular impact upon bony development. But these movement patterns also remain highly plastic, shaped in response to context (e.g. fit and hold during breastfeeding, postural positioning).
Evolutionary bodywork therapy proposes that exercises applied for a period of time a number of times a day to the infant muscles, joints, and tissues can't be expected to change infant neuromuscular patterns.
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Infant suck is an oromotor function which needs to be understood in context. That is, in the context of the infant's whole body (positioning, motoric stability, spinal alignment), in relation to the maternal body.
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If the context isn't changed, then the neuromuscular function won't change (unless the infant is gradually maturing and growing in size, which impacts on function).
You can find out why the tongue usually doesn't have dysfunctional movement patterns causing breastfeeding problems the way you might hear elsewhere.
What does evolutionary biology tell us?
Evolutionary biologists tell us that the human infant has fewer fixed action patterns than any other primate or mammal, and is breathtakingly neuroplastic and responsive to context or environment.
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The human infant is characterised by neoteny, a uniquely human developmental plasticity.
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The environmental context determines how the few reflexes that we are born with actually respond to input.
What does neurodevelopmental science tell us?
I share the view of the growing number of developmental researchers who argue that tiny motor injuries or problems in the infant brain can have a cascading effect on all facets of infant development.
It's also increasingly widely accepted now that the best way to repair many developmental challenges is by using the small child's desire or emotional drive or intention to drive new patterns of motor behaviour and interaction. That is, from this neurodevelopmental perspective, too, addressing postural stability in the context of breastfeeding is likely to be much more effective than performing exercises on the baby.
Busting myths about traditional bodywork therapy for infants #4: the (otherwise well and neurologically intact) infant body is innately competent
Traditional bodywork for babies is built from a belief in the incompetence of the breastfeeding infant once problems emerge, which needs to be fixed by a course of manual therapy. There are two reasons given.
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The infant body has innate neuromuscular incompetence (that is, is born that way)
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The infant body has neuromuscular incompetence because baby's neuromuscular function has been impaired by childbirth.
What does evolutionary biology tell us?
Evolutionary biology teaches us that human anatomy and breastfeeding has been remarkably stable for the past 300,000 years. Every child born carries the robust genetic coding of the past four billion years of evolution of life on Earth and the past six million years of evolution of hominin life. Each little one who arrives in our arms is the epitome of the evolutionary development of life on this planet.
Evolutionary bodywork has confidence in the evolutionary integrity of the human infant and his mother. (Here we are not considering those mother-baby pairs who are dealing with medically diagnosed conditions and illnesses.) It's not innate neuromuscular dysfunctions, but the environmental context in which the infant comes onto the breast which impacts upon suck and creates breastfeeding problems.
Busting myths about traditional bodywork for infants #5: perfection of symmetrical function is not achieved through externally applied treatments and exercises
I don't agree that functional perfection - a kind of perfect symmetry or perfect function - can be achieved by performing the right exercises or manoeuvres upon our babies. This belief is accompanied by the beliefs that
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The bodyworker can fix the imperfection over a course of multiple consultations
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The parent can be taught by the bodyworker to fix the imperfection with regular application of exercises on the baby.
In my view, a baby's healthy neuromuscular function is reinforced by postural alignment (in particular, optimal fit and hold during breastfeeding), driven by the repetitive biological desire to feed and in the context of the mother's or parent's body as one single biological system.
Why has traditional bodywork therapy become so popular in clinical breastfeeding support in countries with advanced economies?
Some folks look at me incredulously when I say I don't believe there is a role for traditional bodywork therapy for babies when breastfeeding problems emerge! So many breastfeeding support providers believe in the importance of traditional bodywork therapy for breastfeeding babies in high income countries now, so much work has gone into it, so many conferences, such detailed teaching, that a dissenting voice is easily framed as ignorant!
But in the big picture, this kind of overservicing - accompanied by conferences and courses and textbooks and online misinformation - is a worsening global problem. You can find out more about the international trend to overtreatments here.
What do studies in global health tell us?
Overdiagnosis, overtreatment, and overservicing is particularly common in affluent societies. I have watched two other great waves of overdiagnosis and overtreatment occur internationally in breastfeeding mothers and their babies in my life-time. Extraordinary amounts of money has been invested in conferences, methodologically weak research studies, and unnecessary and inappropriate treatments about or for reflux and allergy in breastfeeding babies. This trend to overdiagnosis and overservicing is repeated in the diagnoses of fascial restrictions and neuromuscular dysfunctions in babies with breastfeeding problems.
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You can find out about overdiagnosis and overtreatment of reflux here.
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You can find out about overdiagnosis and overtreatment of allergy here.
How can we change the trend to overdiagnosis and overtreatment in breastfeeding babies?
I believe that in ten or twenty years time, traditional bodywork therapy will no longer have a prominent place in breastfeeding support, as more effective methods for helping breastfeeding women and their babies built on the principles of evolutionary bodywork, such as I offer you in Possums Breastfeeding & Lactation, become available.
It is, however, possible that our traditional bodywork therapists, with their deep understanding of embodied healing and neuromuscular dynamics, will embrace and lead this shift towards evolutionary bodywork in the care of mothers and babies. This is my hope.
Recommended resources
Who gives traditional bodywork therapy to breastfed babies and why?
Breastfeeding, orofacial development and traditional bodywork therapy
Nine reasons why traditional bodywork therapy makes life with your baby harder than it needs to be
Selected references
Tedeschi R, Giorgi F. Exploring manual interventions for infantile colic: a scoping review of the evidence. Children. 2025;12(1246):https://doi.org/10.3390/children1209124.