Breastfeeding-Related Musculoskeletal Pain: Posture, Rehabilitation, and Dry Needling
August is National Breastfeeding Month—a time dedicated to increasing awareness, education, and support for breastfeeding families. Much of that support appropriately focuses on the infant: latch, milk transfer, feeding frequency, weight gain, and positioning. But there is another body involved in breastfeeding.
The body doing the feeding.
Breastfeeding can require hours each day in repetitive or sustained positions while simultaneously recovering from pregnancy and birth, functioning on disrupted sleep, carrying and feeding an increasingly heavy infant, and adapting to the physical demands of postpartum life.
So when a breastfeeding patient develops neck pain, thoracic stiffness, shoulder pain, headaches, wrist symptoms, or low back pain, the answer shouldn't simply be:“Sit up straighter.” Breastfeeding is a physical task. And sometimes the person performing that task needs rehabilitation too.
The Physical Demands of Breastfeeding
Consider what happens during a typical feeding session.
A breastfeeding parent may repeatedly:
flex the cervical spine to look down at the baby
maintain the head and neck in a relatively static position
round through the thoracic spine
protract or elevate the shoulders
support the infant with one upper extremity
sustain wrist and hand positions
rotate or side-bend the trunk
remain seated for prolonged periods
repeat the same position multiple times throughout the day—and night
None of these movements is inherently problematic. The issue is often not the posture itself. It is the combination of position, duration, repetition, load and recovery capacity.
Research supports this clinical picture. In one study of 395 breastfeeding women, 84% reported back pain at least once per month. Weekly pain was reported in the cervical, thoracic, and lumbosacral regions, and longer individual feeding sessions and greater total breastfeeding time were associated with pain.
A 2026 study similarly found high rates of postpartum musculoskeletal pain during the first six months of breastfeeding, including low back, neck, thoracic, and shoulder pain. Physical support and ergonomic strategies were also associated with less upper-extremity disability.
In other words: Breastfeeding isn't “just sitting.”
It is a repetitive musculoskeletal demand occurring during one of the most physiologically demanding periods of recovery.
Beyond “Good” and “Bad” Posture
Posture matters—but probably not in the rigid way we once taught it.
There isn't one perfect breastfeeding position that every parent needs to maintain. In fact, trying to hold a supposedly “perfect” posture for 30 minutes may simply replace one sustained position with another. A better rehabilitation question is: Can we make the task easier on the body?
That might mean:
bringing the baby toward the breast rather than repeatedly bringing the trunk toward the baby
supporting the arms rather than continuously holding the baby's weight
supporting the feet and trunk when seated
changing feeding positions throughout the day
using side-lying or reclined positions when appropriate
reducing sustained cervical flexion
alternating sides and positions
using pillows strategically
finding opportunities for movement between feeds
One study found less intense neck pain among mothers who preferred lying positions compared with sitting in a chair or armchair, while other research suggests simply changing breastfeeding positions may help reduce discomfort.
The goal isn't perfect posture. The goal is variability, support, efficiency, and load tolerance.
The Postpartum Body Matters, Too
Breastfeeding-related musculoskeletal pain does not occur in isolation.
The person feeding the baby may also be recovering from:
pregnancy-related changes in movement, loading, and body mechanics
vaginal or cesarean birth
abdominal wall changes
pelvic floor dysfunction
pelvic girdle or low back pain
reduced sleep and recovery
repetitive lifting, carrying, rocking, and feeding
And then we hand them an eight-pound—and rapidly growing—weight and ask them to hold it several hours per day. That context matters. A rehabilitation evaluation should therefore look beyond the painful muscle.
For a patient presenting with breastfeeding-related neck or shoulder pain, for example, the clinical picture may involve cervical mobility, thoracic mobility, scapular control, rib cage mechanics, breathing strategy, upper-extremity loading tolerance, trunk strength, and the ergonomics of feeding itself.
This is where rehabilitation has an important role in breastfeeding support.
Where Does Dry Needling Fit?
Dry needling can be a valuable tool for selected postpartum patients experiencing musculoskeletal pain associated with breastfeeding. But—as with every population we treat—dry needling is not a protocol. We don't needle someone because they breastfeed.
We assess the individual, identify the neuromusculoskeletal impairments contributing to their presentation, and determine whether dry needling is an appropriate tool within a comprehensive rehabilitation plan.
Depending on the examination, treatment may address regions such as the cervical and thoracic musculature, upper trapezius, levator scapulae, periscapular musculature, rotator cuff, pectoral region, lumbar musculature, or other relevant tissues.
The goal is not simply to “release a tight muscle.” Dry needling may be used as a neuromodulatory input to help decrease pain, modify nociceptive input, address myofascial contributors, and create a window in which movement becomes more comfortable. That window is where rehabilitation happens.
Dry needling may help create the reset. Movement provides the reinforcement. Progressive loading builds the capacity.
The intervention becomes:
RESET → REINFORCE → RELOAD
Reset: Use dry needling and other appropriate interventions to modulate pain, decrease sensitivity, and improve access to movement.
Reinforce: Use mobility, movement retraining, breathing strategies, and ergonomic modification to integrate new movement options and reduce unnecessary demand.
Reload: Progressively build strength, endurance, and load tolerance so the patient can better meet the repetitive physical demands of breastfeeding and infant care.
This is the difference between temporarily changing symptoms and creating meaningful, sustainable change. Dry needling may create a window for more comfortable movement, but what we do within that window matters. Mobility restores options, movement retraining reinforces them, and progressive strengthening builds the capacity required for the repetitive demands of breastfeeding and infant care.
Just as importantly, education gives the patient strategies they can actually use at 2:00 AM when they're feeding a baby—not just in the clinic at 2:00 PM. That's the difference between treating the painful tissue and treating the person using it.
Is Dry Needling Safe While Breastfeeding?
This is an important distinction for clinicians.
Breastfeeding itself is not generally considered a contraindication to dry needling. However, postpartum status requires thoughtful clinical screening and individualized decision-making. Clinicians should consider the patient's overall medical status, postpartum recovery, medications, infection risk, bleeding risk, tissue condition, treatment region, and any other relevant precautions or contraindications before proceeding.
While dry needling has an established role in the management of many musculoskeletal pain presentations, research specifically examining dry needling for breastfeeding-related musculoskeletal pain remains limited. This distinction matters. We are not using dry needling to “treat breastfeeding.” We are using it, when clinically appropriate, to address identified neuromusculoskeletal impairments in a patient who happens to be breastfeeding.
As always, treatment decisions should be based on the individual patient's presentation, medical history, clinical examination, and applicable professional standards.
Breastfeeding Support Is Bigger Than Latch
International Board Certified Lactation Consultants (IBCLCs), physicians, midwives, nurses, mental health professionals, and rehabilitation clinicians each bring a different piece of expertise to postpartum care. The physical therapist isn't replacing the lactation consultant. And the lactation consultant shouldn't have to become a musculoskeletal specialist.
This is exactly why interdisciplinary postpartum care matters.
A patient struggling with pain during breastfeeding may benefit from both:
Lactation support to address latch, infant positioning, milk transfer, feeding strategy, and breast-related concerns.
Rehabilitation to address pain, mobility, strength, movement strategy, load tolerance, ergonomics, and neuromusculoskeletal contributors.
Those services complement one another.
Expanding the Rehabilitation Lens
During National Breastfeeding Month, supporting breastfeeding should mean supporting the entire person doing the feeding. That means recognizing that neck pain, back pain, shoulder pain, headaches, and upper-extremity symptoms aren't simply inconveniences someone should tolerate because they have a new baby.
Nor should our solution be reduced to correcting “bad posture.” Breastfeeding is a repetitive physical demand. And physical demands require capacity.
As rehabilitation clinicians, we are uniquely positioned to evaluate how mobility, strength, nervous system sensitivity, positioning, repetitive loading, recovery, and postpartum changes interact—and to intervene when those systems limit comfort or function.
Dry needling can be one valuable tool within that framework. But the needle isn't the endpoint.
Our goal is to decrease unnecessary sensitivity, restore movement options, build capacity, and help patients meet the physical demands of feeding and caring for their baby with greater comfort and confidence.
Because supporting breastfeeding shouldn't stop at helping the baby eat. We should be supporting the body doing the feeding, too.
References
1. Aburub A, Darabseh MZ, Alsharman A, Hegazy MM, Hunter SM. Nursing mothers' experiences of musculoskeletal pain attributed to poor posture during breastfeeding: a mixed methods study. Breastfeed Med. 2022;17(11):926-931. doi:10.1089/bfm.2022.0105.
2. Ratajczak M, Górnowicz R. The influence of breastfeeding factors on the prevalence of back and neck pain: data from an online survey. BMC Musculoskelet Disord. 2024;25:675. doi:10.1186/s12891-024-07785-4.
3. Gürsu S, Ekşioğlu A, Karaca Saydam B, Özkeskin M, Ceber Turfan E. Musculoskeletal pain and related factors in breastfeeding women during the first 6 months. J Community Health Nurs. 2026;43(3):252-263. doi:10.1080/07370016.2026.2642051.
4. Ojukwu CP, Okpoko CG, Okemuo AJ, Ede SS, Ilo IJ. Breastfeeding-related neck pain: prevalence and correlates among Nigerian lactating mothers. Int Health. 2023;15(4):383-388. doi:10.1093/inthealth/ihac050.
5. Rani S, Habiba UE, Qazi WA, Tassadaq N. Association of breast feeding positioning with musculoskeletal pain in post partum mothers of Rawalpindi and Islamabad. J Pak Med Assoc. 2019;69(4):564-566.
6. Australian Society of Acupuncture Physiotherapists. Guidelines for Safe Acupuncture and Dry Needling Practice.Australian Society of Acupuncture Physiotherapists; 2013. Accessed August 24, 2026.
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