When we think about Occupational Therapy (OT) for the nursing dyad, we often hear about the pediatric aspects of this care and benefits to the baby. Amanda Mack, OT, OTD, MS, OTR is an Instructor and Fieldwork Faculty in the Department of Occupational Therapy at MGH Institute of Health Professions in Boston, Mass. who specializes in adult OT and focuses on maternal aspects of feeding.
Mack became interested in maternal child health after the birth of her first daughter and the breastfeeding struggles she surmounted. While attending a local breastfeeding support group, she realized that OT and therapists’ skill sets could be extremely valuable to new parents.
For instance, she heard mothers describe wrist pain and difficulty positioning their babies to nurse. She heard concerns about how to comfortably breastfeed while out to eat and others about how to manage pumping schedules. There were questions about mental health, self-care, infant care, and more.
“All of these things, OT helps address,” Mack says. “We are professional problem solvers.”
Mack goes on to describe OT as “a bit of an enigma.”
“Occupational therapy is a profession that helps people across the lifespan to do the things they want and need to do,” she clarifies. “We focus on helping people participate in their meaningful daily activities, which we call occupations. Breastfeeding and infant feeding, as well as parenting, are very meaningful occupations.”
Mack explains that much of parenting is learning new habits, skills and routines and learning how to cope with the loss of previously established habits and routines.
OTs have training in physiology, mental health, child development, sensory processing, and even feeding which all converge in order to best support new parents.
“We can look at the different aspects involved in infant feeding: the ergonomics, the baby and their development, the mom’s needs, the demands on the mom’s time and body, and many, many other aspects,” Mack explains. “By considering all these different things, we can help deliver holistic care to new moms.”
She uses the example of assessing both mom and baby’s positioning for a comfortable latch at the breast, whereas oftentimes care providers zoom in to just a small piece of the puzzle and examine the baby’s mouth at the breast.
“Another great example is a return to work,” Mack continues. “I’m looking at helping the mom figure out a routine that works; teaching her how to manage the pump and supplies; even educating on her rights and teaching her how to advocate for the breaks and time she needs.”
She adds, “But the place where occupational therapy really shines is when there is another variable making these already difficult things even more difficult. Especially people who may have physical or mental disabilities or illness, we can really use our expertise to help people participate in this very meaningful ‘occupation’ despite the barriers they may be facing.”
Before a mother gives birth, there may be implications for breastfeeding outcomes when and if OT is integrated into prenatal care, but Mack says that this is an emerging area of practice and there’s a need for more research.
She points out that there is some work in Brazil with OTs being part of the prenatal team, an OT at NYU doing work with new and expecting mothers, and some therapists in Australia looking at this topic. But while there are therapists doing the work, there isn’t high-quality research on the outcomes yet, she reports.
Mack adds that she and her colleagues hope to collaborate with local OB-GYNs, midwives, and other care team members to be able to provide these services and collect more data on this in the coming years.
In her primary role as a faculty member at MGH Institute of Health Professions, Mack teaches entry-level occupational therapy doctoral students. Here, she is heavily involved in the IMPACT practice center— an education center where healthcare students provide free care to the community.
Their new parent and infant feeding support group launched in January, which runs every week on Thursday afternoons. They also collaborate with nursing colleagues to provide 1:1 support to expecting and new moms in order to supplement their existing medical care.
Macks says there has been great interest from her students and it helps to broaden their learning experiences.
“Wow, there’s a lot I don’t know yet,” Mack recalls some of her students’ remarks.
She also reports that it helps students see the need for this kind of care; it has drummed up a lot of student advocacy for equitable maternal child care.
“It’s encouraging because they’ll all be practitioners one day,” Mack says.
In the future, Mack and her colleagues hope to complete research on the efficacy of their services and the impacts of other conditions like tongue ties.
What’s more, the team is committed to making sure that underserved communities and Communities of Color have equal access to their services.
In this light, OTs are overwhelmingly white and female. Mack reports that MGH is committed to inclusion and diversity and is working toward diversifying the field.
Most recently, Mack completed the Lactation Counselor Training Course (LCTC) in order to gain a more comprehensive understanding of breastfeeding and how to counsel parents.
“I’ve really enjoyed learning more about what we know about breastfeeding from the literature,” Mack shares. “Much of what I’ve learned about breastfeeding previously is the ‘how’ – but learning the ‘why’ behind it has been really exciting and eye-opening for me! I’ve definitely learned more tricks and tips to bring into my practice.”
She encourages all lactation care providers to connect with OTs in their area or someone they can connect their clients with via telehealth.
“Breastfeeding support takes a village, and OT brings a unique view and lens to supporting new parents.”
Anyone interested in learning more may reach out directly to Mack at email@example.com.