The eight-week program helped mothers with forward head posture improve neck mobility, reduce fatigue, and enhance quality of life compared with routine postpartum care.
- Combining Pilates with breastfeeding positioning improved posture and reduced neck pain in breastfeeding mothers
- Mothers also experienced better neck mobility, less fatigue, greater breastfeeding confidence, and improved quality of life
- Researchers say posture-focused exercises and ergonomic breastfeeding education could support postpartum recovery
A randomized controlled trial published in Scientific Reports found that combining Pilates exercises with breastfeeding positioning adjustments significantly improved posture in breastfeeding women with forward head posture (FHP).
Pilates exercise also reduced neck pain, disability, and fatigue, increased cervical mobility, and enhanced breastfeeding self-efficacy and quality of life (1✔ ✔Trusted Source
Effect of pilates exercises plus breastfeeding positioning adjustment on artificial intelligence-assessed craniovertebral angle in breastfeeding women with forward head posture: a randomized controlled trial
).
The eight-week intervention, evaluated using an artificial intelligence (AI)-based posture assessment system alongside multiple clinical outcome measures, offers one of the first comprehensive rehabilitation strategies specifically designed for postpartum women experiencing breastfeeding-related postural problems.
By addressing both the physical demands of breastfeeding and the underlying musculoskeletal dysfunction, the study provides new evidence that posture-focused exercise and ergonomic breastfeeding education may work together to improve maternal health.
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Can Pilates and Better Breastfeeding Positioning Improve Postpartum Neck Health?
To investigate whether Pilates combined with breastfeeding positioning adjustment could improve forward head posture (FHP), researchers conducted the first randomized controlled trial involving breastfeeding mothers with FHP.
The study evaluated not only posture but also neck pain, disability, neck movement, fatigue, breastfeeding confidence, quality of life, and infant growth, using an artificial intelligence (AI)-based posture assessment system alongside clinical outcome measures.
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At a Glance: Nature Study Design and Major Findings
|
Study Aspect |
Details |
Main Finding |
|
Journal |
Scientific Reports (Nature Portfolio) |
First randomized controlled trial evaluating Pilates with breastfeeding positioning adjustment in mothers with FHP |
|
Participants |
74 breastfeeding mothers with forward head posture |
Randomly assigned into intervention (37) and routine care (37) groups |
|
Intervention |
Eight-week supervised Pilates programme + breastfeeding positioning education |
Combined exercise and ergonomic breastfeeding guidance |
|
Control |
Routine postpartum care |
Used for comparison |
|
Posture assessment |
AI-based Artificial Intelligence Posture Evaluation and Correction System (APECS) measuring craniovertebral angle (CVA) |
Objective evaluation of posture changes |
|
Health outcomes assessed |
Neck pain, neck disability, cervical range of motion, fatigue, breastfeeding self-efficacy, quality of life, and infant growth |
Researchers assessed both physical and functional recovery |
|
Posture outcome |
Craniovertebral angle (forward head posture) |
Improved after the combined intervention |
|
Pain and function |
Neck pain, disability, and cervical mobility |
Neck pain and disability decreased, while neck mobility improved |
|
Maternal well-being |
Fatigue, breastfeeding self-efficacy, and quality of life |
Fatigue was reduced, and mothers reported greater breastfeeding confidence and better quality of life |
|
Infant outcome |
Growth parameters |
Improvements were observed, although larger studies are needed to confirm these findings |
|
Overall conclusion |
Pilates combined with breastfeeding positioning adjustment |
More effective than routine postpartum care alone for improving posture and maternal musculoskeletal health |
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Why Are Breastfeeding Mothers More Prone to Forward Head Posture and Neck Pain?
Mothers often spend long periods feeding their babies while maintaining awkward neck and shoulder positions, which can gradually lead to forward head posture (FHP) and neck pain.
Several factors contribute to this increased risk:
- Prolonged neck bending while helping the baby latch.
- Repeated feeding sessions throughout the day that strain the neck and upper back.
- Leaning towards the baby instead of bringing the baby closer to the breast.
- Hormonal changes after childbirth that reduce joint stability.
- Weak core and postural muscles following pregnancy.
- Sleep deprivation and repetitive infant handling, which increase muscle fatigue.
These factors place continuous stress on the cervical spine, increasing the risk of neck pain, headaches, shoulder discomfort, muscle fatigue, and restricted neck movement.
The high burden of breastfeeding-related neck pain is reflected in a cross-sectional study published in the International Health journal.
Among 310 breastfeeding mothers, 51.7% reported neck pain, with more than half describing it as moderate.
Around 60% experienced pain during breastfeeding, while 83.3% reported that changing breastfeeding positions helped relieve their symptoms. These findings highlight the importance of proper breastfeeding ergonomics alongside targeted rehabilitation exercises (2✔ ✔Trusted Source
Breastfeeding-related neck pain: prevalence and correlates among Nigerian lactating mothers
How Does the Latest Evidence Improve Our Understanding of Pilates for Neck Pain?
Although earlier research suggested that Pilates could help relieve chronic neck pain, the overall evidence remained limited.
A systematic review and meta-analysis published in the Journal of Bodywork and Movement Therapies found that differences in study design, participant groups, exercise programs, and treatment duration made it difficult to draw firm conclusions (3✔ ✔Trusted Source
Pilates for neck pain: A systematic review and meta-analysis of randomised controlled trials
The latest findings address many of these gaps by evaluating Pilates in breastfeeding women with forward head posture, combining exercise with breastfeeding positioning adjustment, and measuring a wider range of maternal health outcomes.
The key differences between earlier research and the latest evidence are summarized below.
Comparison of Earlier Pilates Research and the Latest Evidence
|
Research Area |
Earlier Pilates Research |
Latest Evidence |
|
Who was studied? |
Adults with general neck pain |
Breastfeeding women with forward head posture |
|
Main approach |
Pilates alone in most studies |
Pilates combined with breastfeeding positioning adjustment |
|
Research quality |
Evidence considered low because of small studies and inconsistent methods |
Randomized controlled trial using a standardized 8-week program |
|
How was posture measured? |
Mostly routine clinical assessment |
AI-based APECS system measuring the craniovertebral angle (CVA) |
|
What was evaluated? |
Mainly neck pain and disability |
Posture, neck pain, disability, neck mobility, fatigue, breastfeeding self-efficacy, quality of life, and infant growth |
|
Key message |
Pilates showed potential benefits, but stronger evidence was needed. |
Combining Pilates with better breastfeeding positioning produced broader improvements in maternal health than routine postpartum care. |
How Can Better Breastfeeding Positioning Reduce Neck Strain?
The combined Pilates and breastfeeding positioning program showed better outcomes than routine postpartum care, suggesting that exercise alone may not be enough to reduce breastfeeding-related neck pain.
According to UNICEF, comfortable positioning helps both the mother and baby achieve a good latch while reducing unnecessary strain on the neck, shoulders, and upper back (4✔ ✔Trusted Source
Common breastfeeding positions
To improve breastfeeding posture, mothers are encouraged to:
- Bring the baby to the breast instead of leaning forward.
- Keep the baby’s head, neck, and body in a straight line for easier attachment.
- Hold the baby close to the body, supporting the shoulders and back rather than only the head.
- Use pillows or cushions to support the baby’s weight and reduce pressure on the neck and shoulders.
- Choose a comfortable feeding position, such as the cradle, cross-cradle, football, or side-lying hold.
- Ensure both mother and baby are comfortable and relaxed before feeding to avoid unnecessary muscle tension.
- Encourage skin-to-skin contact whenever possible, as it promotes natural positioning and effective breastfeeding.
These simple adjustments can help maintain a neutral posture, improve breastfeeding comfort, and reduce repeated stress on the cervical spine during frequent feeding sessions.
Why Is Breastfeeding Positioning Important for Long-Term Recovery?
Proper breastfeeding positioning not only improves feeding comfort but may also reduce the risk of persistent neck pain and postural problems.
More than 83% of breastfeeding mothers with neck pain experienced relief after changing their feeding position, highlighting the importance of good breastfeeding ergonomics.
When combined with postural exercises such as Pilates, better positioning may help:
- Reduce repeated neck and shoulder strain.
- Improve spinal alignment during feeding.
- Lower muscle fatigue.
- Support long-term recovery from forward head posture.
- Improve breastfeeding comfort and confidence.
- Encourage longer, more relaxed feeding sessions.
Together, these findings suggest that combining targeted exercises with proper breastfeeding positioning may provide a simple, non-drug approach to improving maternal musculoskeletal health.
While larger studies are still needed, adopting good breastfeeding ergonomics early after childbirth could help prevent long-term neck pain while supporting a more comfortable breastfeeding experience.
Frequently Asked Questions
Q: Can Pilates help improve breastfeeding posture?
A: Yes. The latest randomized controlled trial found that an eight-week Pilates program combined with breastfeeding positioning education improved forward head posture, neck mobility, and overall comfort in breastfeeding women with forward head posture. However, larger studies are needed to confirm these findings in broader populations.
Q: What is forward head posture during breastfeeding?
A: Forward head posture (FHP) occurs when the head shifts in front of the shoulders due to prolonged neck bending or poor posture. During breastfeeding, repeatedly leaning toward the baby instead of bringing the baby to the breast can increase strain on the neck, shoulders, and upper back, contributing to pain and muscle fatigue.
Q: How long does it take for Pilates to improve postpartum posture?
A: In the study, participants followed a supervised Pilates program for eight weeks. By the end of the intervention, researchers observed improvements in posture, neck pain, cervical mobility, fatigue, breastfeeding confidence, and quality of life compared with routine postpartum care.
Q: What are the best breastfeeding positions to reduce neck pain?
A: Health experts recommend positions that keep the mother’s spine in a neutral alignment, such as the cradle hold, cross-cradle hold, football hold, and side-lying position. Using pillows to support the baby and bringing the baby to the breast instead of leaning forward can also help reduce neck and shoulder strain.
Q: Is neck pain common among breastfeeding mothers?
A: Yes. Research indicates that neck pain is common during breastfeeding because of frequent feeding sessions and prolonged postures. One cross-sectional study found that over half of breastfeeding mothers reported neck pain, and many experienced symptom relief after improving their breastfeeding position.
Q: Can exercise improve breastfeeding confidence and quality of life?
A: The latest study suggests it can. Mothers who participated in the combined Pilates and breastfeeding positioning program reported greater breastfeeding self-efficacy, reduced fatigue, and better quality of life than those receiving routine postpartum care alone. More research is needed to determine whether these benefits persist over the long term.
References:
- Effect of pilates exercises plus breastfeeding positioning adjustment on artificial intelligence-assessed craniovertebral angle in breastfeeding women with forward head posture: a randomized controlled trial – (https://www.nature.com/articles/s41598-026-63711-9)
- Breastfeeding-related neck pain: prevalence and correlates among Nigerian lactating mothers – (https://pmc.ncbi.nlm.nih.gov/articles/PMC10318971/)
- Pilates for neck pain: A systematic review and meta-analysis of randomised controlled trials – (https://www.bodyworkmovementtherapies.com/article/S1360-8592(22)00054-7/abstract)
- Common breastfeeding positions – (https://www.unicef.org/parenting/food-nutrition/breastfeeding-positions)
Source-Medindia