Motherhood after Spinal Cord Injury: Breastfeeding, Autonomic Dysreflexia, and Psychosocial Health: Clinical Practice Guidelines

Author:

Krassioukov Andrei1234,Elliott Stacy156,Hocaloski Shea6,Krassioukova-Enns Olga7,Hodge Karen8,Gillespie Stephanie9,Caves Sherry10,Thorson Teri11,Alford Lindsay4,Basso Melanie9,McCracken Laura1,Lee Amanda1,Anderson Kim12,Andretta Elena13,Chhabra Harvinder Singh14,Hultling Claes15,Rapidi Christina-Anastasia16,Sørensen Fin-Biering17,Zobina Ineta18,Theron Francois19,Kessler Allison20,Courtois Frederique21,Berri Maryam22

Affiliation:

1. 1International Collaboration on Repair Discoveries (ICORD), Vancouver, BC, Canada

2. 2Department of Medicine, University of British Columbia, Vancouver, BC, Canada

3. 3Division of Physical Medicine & Rehabilitation, University of British Columbia, Vancouver, BC, Canada

4. 4GF Strong Rehabilitation Centre, Vancouver, BC, Canada

5. 5Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada

6. 6Sexual Health Rehabilitation Service, GF Strong Rehabilitation Centre, and Sperm Retrieval Clinic, Blusson Spinal Cord Centre, Vancouver, BC, Canada

7. 7Axioms of Inclusion, Winnipeg, Manitoba, Canada

8. 8Adaptability Counselling and Consultation, Vancouver, BC, Canada

9. 9BC Women's Hospital, Vancouver, BC, Canada

10. 10Vancouver, BC, Canada

11. 11Spinal Cord Injury BC, Vancouver, BC, Canada

12. 12Department of Physical Medicine and Rehabilitation, MetroHealth Medical Center, and Case Western Reserve University School of Medicine, Cleveland, Ohio

13. 13Highly Specialized Rehabilitation Hospital, Motta di Livenza, Treviso, Italy

14. 14Indian Spinal Injuries Centre, New Delhi, India

15. 15Karolinska Institutet, Spinalis Foundation, Stockholm, Sweden

16. 16Physical & Rehabilitation Medicine Department General Hospital “G. Gennimatas,” Athens, Greece

17. 17Clinic for Spinal Cord Injuries, Rigshospitalet, Denmark

18. 18Welsh Spinal Cord Injury Rehabilitation Centre (WSCIRC), Cardiff, United Kingdom

19. 19Muelmed Rehabilitation Centre and Department of Orthopedic Surgery, University of Pretoria, Pretoria, South Africa

20. 20Department of Physical Medicine & Rehabilitation, Northwestern University Feinberg School of Medicine and Renée Crown Center for Spinal Cord Innovation, Chicago, Illinois

21. 21Department of Sexology, Université du Québec à Montréal, Montreal, QC, Canada

22. 22Department of Physical Medicine and Rehabilitation at the University of Michigan Medical School, Ann Arbor, Michigan

Abstract

The World Health Organization (WHO) recommends that children be breastfed exclusively for the first 6 months of age. This recommendation may prove challenging for women with spinal cord injury (SCI) who face unique challenges and barriers to breastfeeding due to the impact of SCI on mobility and physiology. Tailored provision of care from health care professionals (HCPs) is important in helping women navigate these potential barriers. Yet, HCPs often lack the confidence and SCI-specific knowledge to meet the needs of mothers with SCI. An international panel of clinicians, researchers, consultants, and women with lived experience was formed to create an accessible resource that can address this gap. A comprehensive survey on breastfeeding complications, challenges, resources, and quality of life of mothers with SCI was conducted, along with an environmental scan to evaluate existing postpartum guidelines and assess their relevance and usability as recommendations for breastfeeding after SCI. Building on this work, this article provides evidence-based recommendations for HCPs, including but not limited to general practitioners, obstetricians, pediatricians, physiatrists, lactation consultants, nurses, midwives, occupational therapists, and physiotherapists who work with prospective and current mothers with SCI.

Publisher

American Spinal Injury Association

Reference36 articles.

1. Spinal cord injury community survey: Understanding the needs of Canadians with SCI;Noreau;Top Spinal Cord Inj Rehabil,2014

2. World Health Organization . Breastfeeding recommendations. 2021.Accessed December 25, 2023. https://www.who.int/health-topics/breastfeeding#tab=tab_2

3. Predicting intention and maintenance of breastfeeding up to 2-years after birth in primiparous and multiparous women;Grano;Psychol Health,2023

4. Breastfeeding rates and hospital breastfeeding practices in Canada: A national survey of women;Chalmers;Birth,2009

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