Breastfeeding Challenges- a Window to your Baby’s Brain

I am a very lucky person.  Not everyone can say that their life’s work is truly beneficial to man (and woman) kind.  I can.  I became a Chiropractor a little later in life, after I already had 2 children.  It was an easy pathway for me to focus on maternity and pediatric care.  However, in the last 10-15 years, that pathway has taken me deep down the road of breastfeeding support.  It’s truly my happy place- helping parents and babies to not only feed better, but to LIVE easier.  Anyone reading this article who has children and who has struggled with breastfeeding knows what I mean by that statement.   As I continue to learn and grow as a doctor and a teacher, another truth is becoming ever so clear to me… that the very same neuro-biomechanical origins of feeding challenges, if not resolved early on, are the very same origins of a myriad of developmental and neuro-social challenges that are a growing concern with our youth.

Let’s start this discussion by looking at some sobering facts about our youth today.  According to the CDC (Centers for Disease Control), the reported rate of autism in 1970 was 1 in every 10,000 children.  The reported rate in 2016 was 1 in every 68 children.  In 2025, the reported rate of autism in the US is 1 out of every 34 children. That is double the number from just 9 years ago.  At the same time, 1.44 million children between the ages of 5-11 received medication for mental health issues in 2019. Another report showed that 8.25% (or 4.5 million) children in elementary and secondary schools in the US received specialized accommodation or instructions through an IEP program. One could argue that many of these rising numbers are due to better testing and reporting.  I don’t doubt that.  Regardless of that fact, these numbers are undoubtedly rising steadily at an alarming rate.

In 2022, the same CDC agency released an update to the traditionally accepted ages for developmental milestones.  The normal timing of all activities, such as rolling, sitting, crawling, walking and speaking were postponed to later ages.  The previously key milestone of crawling- which for many decades was looked at as the most critical activity of all for the child’s normal neurological development- was removed entirely! Why would they change those critical milestones, we ask?  Well… I’ve read that, simply put, there were so many children who are delayed that the atypical is now being accepted as the new normal.  THAT is concerning to say the least.

Let’s step back a minute and look at the beginning of life outside of the womb.  The simple process of being born can be a significant trauma to the newborn infant and result in injury that may not be acknowledged.  The forces involved in a normal spontaneous delivery have been measured to be approximately 29 pounds of pressure on the delicate newborn head and spine. In the event of a more complicated delivery involving the use of forceps or vacuum extraction, the measured forces are up to 69 pounds of pressure (1).  Compare that to 56 pounds of pressure reported to cause a whiplash type “sheering force in the cervical spine” of a fully formed adult head and spine (2).  Putting those forces into perspective, you can see how the birth process can dramatically affect the delicate spine and cranium of the newborn.  I would be remiss here if I didn’t mention that the proper alignment of the mother’s pelvis and her fully functioning nervous system are critical factors in the outcome of birth.  Prenatal chiropractic care can help to avoid birth trauma before it happens.

Now, let’s look at some simple anatomy.  The newborn’s spine is mostly cartilage, not fully ossified (becoming solid bone) until almost 20 years of age. The sutures that connect the cranial bones are not fused, allowing the entire cranium to compress in upon itself, many of the bones overlapping each other, allowing it to fit through the birth canal with as little damage as possible.

Let’s just look further at a few structures that interface with the nervous system in a profound way. One fascinating piece of the puzzle is the union between the Occiput and the first cervical vertebra.  We call this the Atlanto-Occipital junction.  The Occiput, or what the lay person would think of as the back of the head, is in 4 pieces in the newborn, connected by flexible cartilage. The result of that design is that it bends! This gives the entire cranium the ability to move and distort (in relationship to the other bones around it) as it passes through the birth canal; thereby protecting the brain, spinal cord and nerves from excessive damage.  The bottom-most part of the Occiput is a large opening called the Foramen Magnum which stays mostly perpendicular, forming the base of the cranium.  This amazing piece of ingenuity, due to the cartilage connections, acts similar to a spring, also for the purpose of protecting the brain stem region from excessive damage from the forces of birth.  The condyles of the Foramen Magnum surround the brainstem and contain many life-sustaining cranial nerves including:

• The Vagus Nerve CNX- Likely the most important and life sustaining nerve in the entire body responsible for all major vital organ systems such as heart, lungs, and digestion.  Recent studies of the Vagus nerve reveal that there is also a ventral branch that regulates our social and emotional state.
• The Hypoglossal Nerve CNXII- The main innervation to the tongue, vital for breastfeeding (and all feeding and speech).
• The Glossopharyngeal Nerve CN IX- the main innervation to all of the muscles of swallowing.

Let’s take a closer look at one part of the Vagus nerve that I mentioned- the ventral branch that helps to regulate our social and emotional state.  Dr. Stephen Porges, PhD, is famed by his ground-breaking research into this ventral branch and developed what is now known as the Polyvagal Theory.  In a nutshell, this branch senses of the person is safe in their environment.  If they are not, if they are feeling unsafe or threatened, this branch of our nervous system acts to protect us.  This protection process can be expressed by a heightened state of agitation, both physically (i.e. increased inflammation, decreased blood flow to internal organs, etc…) and emotionally (anxiety or rage).  It can also be expressed as causing the person to freeze or shut down if the stimulation is too much.  The simple act of an infant being held skin/skin with its mother, feeling protected and warm, AND receiving it’s basic life sustaining need of milk whenever it’s needed… breastfeeding… is one of the baby’s earliest Polyvagal programming.  This basic need being met in such a close and loving way imprints a message that they are SAFE. This message of safety later goes a long way in how that human reacts to its environment for the rest of its life.

In addition to these vital cranial nerves, the brainstem itself plays a crucial role in the growing child by integrating sensory information about the world around them. Specifically, the vestibular nuclei within the brainstem receives signals from proprioceptors- sensory receptors located in muscles, tendons, joints, and the inner ear.  This information is then transmitted from the vestibular nuclei to specialized areas of the cortex, including the primary sensory areas (visual, auditory, somatosensory) and association areas. These areas work together to process and interpret input from different senses, allowing for a coherent perception of the environment.  Interruptions in the transmission of this information can lead to a myriad of neuro-developmental delays and, if not resolved early in life, the older child has to learn ways to adapt to the misconstrued sensory information.  In many cases, this whole adaptation and misinformation process proves too taxing on the developing nervous system and the result is an overstimulated human who is at constant battle with their environment.

The other half of the atlanto-occipital junction is the ATLAS, otherwise known as at the first cervical vertebra, or C1. This first spinal segment is in 3 pieces in the newborn, also connected by flexible cartilage.  The Occiput and the atlas are perfectly designed to fit together just like a Lego. One does not move without the other.  Due to the forces of birth, this area is often strained and misaligned. The results in what we commonly call “torticollis”.  If the infant favors turning the head to one side more than the other or tilts the head to one side, commonly making it more difficult to breastfeed on one breast vs. the other, this is due to the misalignment of this atlanto-occipital union. When this occurs, these all-so-important cranial nerves become compromised in their location in the fibrous Foramen magnum, which interrupts their normal function.

In the infant/mother dyad, this scenario often presents as breastfeeding challenges. The tongue muscles can be weak due to Hypoglossal Nerve interruption. There is often reflux, excess gas, and colic due to irritation of the Vagus Nerve.  The overall distortion of the cranium often leads to TMJ (jaw) imbalance, an overly high palate and tethering of the tongue muscles, leading to challenges on the part of the infant to breastfeed normally. 

Another vital part of infant neuroanatomy is the Sphenobasilar joint. This is a flexible joint in the interior of the cranium (later fused as an adult) between the Occiput and the Sphenoid bones that allows the A LOT of motion in the anterolateral plane of the cranium. The proper alignment of the Sphenobasilar joint determines the height of the palate.  If it is extended or flattened out which often looks like an elongated cranium or “conehead, this draws up the palate and makes it much more difficult for the baby to achieve a normal seal for the transfer of milk.

Another vital function of this joint is to act as the normal pumping mechanism of the cerebral spinal fluid throughout the spinal canal.  Under normal conditions, the Sphenobasilar joint and the sacrum (in the pelvis) move in balance with each other and pump this fluid evenly throughout the spinal canal and the cranium. Interruption of this rhythm, caused by cranial and spinal distortions, causes an increased pressure in this system and can result in an overall pathological tension and over stimulation in the nervous system. This “overstimulation” often presents as a high tension, over stimulated, colicky, constipated, and just overall very unhappy baby (or older child if not resolved).

At the same time, these interruptions that show up at feeding challenges, if not addressed early on, can absolutely lead to disconnections in normal neurological development.

Dr. John Upledger, DO, the creator and developer of cranial sacral therapy, has said…

“If both sides of the occipital base are severely compressed, it’s common to see colic; food regurgitation; esophageal reflux; respiratory difficulties, rapid heart rate; and compromised bowel function (constipation or diarrhea). There also may be rapid heart rate, and compromised bowel function.  If left untreated, the situation may result in a hyperactive child syndrome and attention deficit disorder…  A tight membrane system manifests as a gross dysfunction of the child’s central nervous system. Sensory and motor deficits, while extremely variable, are obvious…  If allowed to persist, the noncompliant membrane Syndrome may be severe enough to become a strong contributing factor to the development of autism”. (3)

A 2005 study in the Journal of Developmental Behavioral Pediatrics takes a look at the relationship between cranial asymmetry and neuro-developmental challenges later on in the child’s life…

“Overall, findings suggest that isolated craniosynostosis – and cranial asymmetry- is associated with a 3- to 5-fold increase in risk for cognitive deficits or learning/language disabilities… and that suggested that school-aged children with DP were at increased risk for developmental delays and required special education services more frequently than their non-affected siblings” (4).

This study was validated by a more current study (2019) showing the same findings (5)

I often say in my classes that the greatest benefit of working with the breastfeeding dyad is that we, pediatric Chiropractors, have the opportunity to get our hands on more babies to deliver skilled adjustments that serve, not only to restore the breastfeeding relationship (which, in and of itself, is a critical aspect of the physical and emotional health of the baby), but it also serves as early intervention of neurodevelopmental challenges.  The very same subluxations or misalignments (stress, strain, trauma, etc…) that initially interrupts the baby’s ability to feed, later can interrupt the way the child can or cannot interact normally with their environment.  Here’s my personal mission statement:

This is my vision-

That every lactation consultant in the hospital, every pediatrician, every dentist performing the releases… will know to send that baby, struggling to breastfeed, to a skilled pediatric Chiropractor to be adjusted because, guess what??? That will save breastfeeding relationships, which is no doubt important, but guess what else???  Regardless of feeding issues, we will get our hands on that baby to Remove Subluxation, which will then protect and elevate that baby for the rest of its life.

-Dr. Lynn Gerner, DC, FICPA, IBCLC

References

• “Differentiating the impact of biomechanical forces of labor and delivery vs. the effect of a posterior tongue tie on neonatal and infant feeding dysfunction: a clinical evaluation”, By Andrew Dorough DC, CACCP, Sharon Vallone, DC, FICCP, Journal of Clinical Chiropractic Pediatrics, Nov. 2023.
• “A Comprehensive Review of Low-Speed Rear Impact Volunteer Studies and a Comparison to Real-World Outcomes”, Joseph Cormier, PhD, Lisa Gwin, DO, Lars Reinhart, MD, Rawson Wood, MD, and Charles Bain, MD, Spine (Phila Pa 1976). 2018 Sep 15; 43(18): 1250–1258.  Published online 2018 Feb 27.
• John Upledger, DO, OMM, Applications of CranioSacral Therapy in Newborns and Infants, Part1, Massage Today, May 2003, Vol. 03, Issue 05.
• “Neurodevelopmental Implications of Deformational Plagiocephaly”, Brent Collett, et al, J Dev Behav Pediatr. 2005 Oct;26(5):379–389.
• “Plagiocephaly and Developmental Delay: A Systematic Review”, Alexandra L C Martiniuk , Cassandra Vujovich-Dunn, Miles Park, William Yu, Barbara R Lucas, J Dev Behav Pediatr. 2017 Jan;38(1):67-78.