Preferred Breastfeeding Postures and Factors Associated With Musculoskeletal Problems in Peshawar: A Cross-Sectional Study
Article Sidebar
Main Article Content
Abstract
Background: Breastfeeding is essential for infant health and maternal–infant bonding, but repeated feeding sessions may expose mothers to sustained static postures and musculoskeletal strain. Maternal postural discomfort during breastfeeding remains under-addressed in routine postnatal care, particularly in local Pakistani settings. Objective: To determine preferred breastfeeding postures and assess breastfeeding-related factors associated with musculoskeletal problems among lactating mothers in Peshawar. Methods: This cross-sectional observational study was conducted at the EPI Centre of Hayatabad Medical Complex, Peshawar. Breastfeeding mothers aged 18–45 years who had breastfed for more than two weeks were recruited using non-probability convenience sampling. Of 235 mothers initially assessed, 230 were included in the final analysis. Data were collected using demographic questions, breastfeeding posture images, breastfeeding-practice items, and the Nordic Musculoskeletal Questionnaire framework. Frequencies and percentages were calculated, and associations were assessed using chi-square testing. Results: Cradle hold was the most commonly preferred posture, reported by 153 mothers (66.5%), followed by cross-cradle hold in 46 (20.0%) and side-lying in 31 (13.5%). Lower back pain was reported by 51 mothers (22.2%), shoulder pain by 46 (20.0%), and upper back pain by 23 (10.0%). Upper back pain was significantly associated with maternal age (p = 0.045) and number of breastfeeding sessions per day (p = 0.022). Conclusion: Cradle hold was the dominant breastfeeding posture, while lower back and shoulder pain were the most frequent complaints. Maternal age and breastfeeding frequency were associated with upper back pain, supporting the need for ergonomic breastfeeding education in postnatal care
Article Details
Issue
Section
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
References
1. Mekebo GG, Argawu AS, Likassa HT, Ayele W, Wake SK, Bedada D, et al. Factors influencing exclusive breastfeeding practice among under-six months infants in Ethiopia. BMC Pregnancy Childbirth. 2022;22(1):1-10.
2. Rani S, Habiba UE, Qazi WA, Tassadaq N. Association of breastfeeding positioning with musculoskeletal pain in postpartum mothers of Rawalpindi and Islamabad. J Pak Med Assoc. 2019;69(4):564-6.
3. D’Souza S, Thomas T, Paul S. Comparison of two breastfeeding positions on maternal comfort and infant feeding behaviors through video teaching among postnatal mothers. J Health Allied Sci NU. 2019;9(3):104-15.
4. Alazmi AA, Algabbani MF. Musculoskeletal pain prevalence and association with breastfeeding position in lactating mothers in Riyadh, Saudi Arabia: a cross-sectional study. Clin Exp Obstet Gynecol. 2023;50(11):250.
5. Rana UI, Irfan A, Saleem S, Hussain IT, Zahid N, Waheed Z. Comparison of breast-feeding positions related to neck pain among lactating mothers. J Riphah Coll Rehabil Sci. 2024;12(3).
6. Younus A, Muneer M, Anjum O. Association of myofascial trigger points in upper trapezius with postural stress among lactating mothers. 2025.
7. 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(1):675.
8. Sharma AM, Roopa R. Exploring modern breastfeeding practices: an insight into optimal positioning for today’s mothers.
9. Irfan A, Rana UI, Hussain IT, Saeed U, Tahir H, Ahmad MT. Frequency of musculoskeletal discomforts and its association with various breastfeeding positions among nursing mothers. MedERA J CMH LMC IOD. 2023;5(2).
10. Womsi RT, Ghassi HT, Kenmogne AFT, Kendjoua JAN, Buh FC, Douryang M, et al. Postpartum stress and the occurrence of breastfeeding-related spine musculoskeletal disorders among lactating mothers in the Dschang Health District, Cameroon. Cureus. 2025;17(3).
11. Mbada CE, Olowookere AE, Faronbi JO, Oyinlola-Aromolaran FC, Faremi FA, Ogundele AO, et al. Knowledge, attitude and techniques of breastfeeding among Nigerian mothers from a semi-urban community. BMC Res Notes. 2013;6:1-8.
12. Ojukwu CP, Ezeukwu OA, Anih CF, Okemuo AJ, Ezugwu UA, Ikele CN, et al. Evaluation of trunk muscle activities in response to three breastfeeding positions utilised by women. J Back Musculoskelet Rehabil. 2021;34(6):1015-21.
13. Yuan TP, Purushothaman VK, Muniandy Y, Pillai SGK. Prevalence and factors associated with neck and low back pain among breastfeeding mothers in the Klang Valley. J Health Transl Med. 2022;25(2):129-34.
14. 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):383-8.