Postural Mechanics and Musculoskeletal Impact of Habitual Breastfeeding Positions: A Clinical Study on Forward Head Posture and Cervico-Scapular Muscle Imbalance in Lactating Mothers
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Background: Breastfeeding requires repeated and sometimes prolonged maternal positioning, which may increase mechanical demands on the cervical spine and scapular stabilizing musculature. Despite increasing recognition of breastfeeding-related musculoskeletal complaints, objective evidence linking habitual feeding posture with measurable postural alterations remains limited. Objective: To determine the association between cradle-lying breastfeeding exposure, forward head posture, and cervico-scapular muscle imbalance in lactating mothers. Methods: This analytical cross-sectional study included 76 lactating mothers aged 18–45 years with infants aged up to 11 months. Cradle-lying exposure was assessed using the Cradle-Lying Exposure Scale. Forward head posture was evaluated by measuring the craniovertebral angle through digital photogrammetry, while cervico-scapular muscle performance was assessed using isometric muscular endurance tests. Descriptive statistics, correlation analysis, and chi-square testing were applied. Results: High cradle-lying exposure was observed in 57% of participants. Moderate and severe forward head posture were present in 40% and 26%, respectively, while approximately 82% demonstrated cervico-scapular muscle imbalance. Mean deep neck flexor endurance was 19.28 ± 10.09 seconds. Cradle-lying exposure showed a significant inverse association with craniovertebral angle (r=−0.532, 95% CI −0.676 to −0.348; p<0.001). Forward head posture severity was strongly associated with muscle imbalance (r=0.727, 95% CI 0.600–0.818; p<0.001), with a significant categorical association, χ²(4)=11.543, p=0.021. Conclusion: Greater cradle-lying exposure was associated with greater forward head deviation, while increasing postural severity was associated with greater cervico-scapular muscle imbalance. These findings support consideration of breastfeeding ergonomics and postural assessment in postpartum care without establishing causality
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