Breastfeeding 101: From Boobs to Bottoms

Let’s get real: breastfeeding is sold to us like it’s this ethereal, natural, whispery moment of mother-baby bliss. But in reality? Sometimes it’s more like “Why is one boob a super soaker and the other one’s on strike?” and “Why do I feel like my uterus is throwing a tantrum every time the baby latches?”

As a pelvic floor therapist, I prioritize having lactation consultant referrals at the ready, especially for first time moms. Here's breastfeeding 101 to start with, keeping in mind the top half and the bottom half of your body are totally connected. So grab your peri bottle and a heating pad, and let’s dive in.

First, Let’s Talk Nipples (yes, we’re going there)

Nipple pain is not a badge of honor. It’s a flashing neon sign that something isn’t quite right. The top culprit? A shallow latch. Translation: your baby is chomping more on the tip than taking in the full areola. This leads to cracked nipples, milk transfer issues, and often painful feeds for mom.

Good latch = happy baby + happy boobs. And if you're thinking, "But they told me this would come naturally!"  let me assure you: breastfeeding is a learned skill, not a magical instinct. Getting help from a lactation consultant early on is not a luxury it’s a necessity.

Bonus: A shallow latch or tension while nursing can affect your posture, which (spoiler alert) affects your pelvic floor. Which brings us to...

Your Perinatal Pelvic Floor

Your pelvic floor is working overtime, mama. During pregnancy, it supported a growing baby. During birth, it either moved aside for the baby to exit or braced for surgical entry. Now? It’s navigating hormonal changes, poor posture from cluster feeds, and that adorable 7-pound boss who demands milk every 2.5 seconds.

Breastfeeding releases oxytocin, the “love” hormone, but it also triggers afterbirth contractions. If you’re wondering why your uterus feels like it’s doing CrossFit in the first week postpartum, that’s why. These cramps are stronger if it’s not your first rodeo. Thanks, biology.

And let’s not forget: the same hormonal cocktail that helps your milk flow also makes your tissues more relaxed and... stretchy. So if you’re peeing when you sneeze, or avoiding stairs, it’s time to see a pelvic floor therapist. (No, you don’t need to “just wait it out.”)

Positioning: It’s Not Just for the Baby

Your breastfeeding position should support your whole body - not just the baby. Slumping on the couch with one boob out and your pelvis tucked under? Not ideal.

Try this instead:

• Sit upright with your pelvis neutral - think proud mom, not melted candle.

• Use pillows, armrests, and footstools. Your baby shouldn’t feel like a kettlebell you’re lifting for reps. The baby should be propped and brought to YOU, not vice versa.

• Side-lying is another great breastfeeding position: it’s restful, supportive, and a lifesaver at 3 AM.

The goal: comfort in your spine, neck, shoulders, and pelvic floor. Because guess what? If you're clenching your jaw while nursing, odds are you're clenching down below too. Your pelvic floor mirrors your facial tension, seriously.

The Emotional Side: You're Not Alone

Some moms love breastfeeding from day one. Others feel like they’re riding a hormonal rollercoaster with cracked nipples and stained shirts. Both are normal. What’s not normal? Feeling like you're failing because it's hard.

Breastfeeding is teamwork between you, your baby, and your support system. That might include a lactation consultant, pelvic floor therapist, postpartum doula, your partner, mental health therapist and maybe even that one friend who keeps dropping off meals.

Final Words from Your Friendly Boob-and-Bottom Expert

Here’s the truth: you deserve to feel good in your body while feeding your baby. Whether that’s breast, bottle, pumping, or a combo, it should work for both of you. You’re not just a milk machine. You’re a recovering, healing, amazing human who just performed the miracle of life and is now keeping that life alive (on little to no sleep).

So let’s make sure your nipples, pelvis, posture, and sanity are all getting the love they deserve.

Need support? We’re here for you from first latch to your last leak. Let’s get you comfy, confident, and maybe even peeing without crossing your legs.

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References:

• Taj, Shazia, et al. “Effectiveness of Breastfeeding Techniques to Improve Latching and Prevention of Nipple Soreness among Primipara Mothers: A Randomized Control Trial.” Journal of Neonatal Surgery, vol. 14, no. 1S, 7 Feb. 2025, pp. 852–859.

• Kent, Jacqueline C., et al. “Nipple Pain in Breastfeeding Mothers: Incidence, Causes and Treatments.” International Journal of Environmental Research and Public Health, vol. 12, no. 10, 29 Sept. 2015, pp. 12247–12259.

• Buck, Miranda L., et al. (CASTLE Study Team)"The Effectiveness of the Laid-Back Position on Lactation-Related Nipple Problems and Comfort: A Meta-Analysis.” BMC Pregnancy and Childbirth, 2021.

• Pardo, E., et al. “The Impact of Breastfeeding on Pelvic Floor Recovery from Pregnancy and Labor.” European Journal of Obstetrics and Gynecology and Reproductive Biology, vol. 255, 2020, pp. 90–95.

• Susser, Julie A., et al. “Breastfeeding and Pelvic Floor Disorders One to Two Decades After Vaginal Delivery.” American Journal of Obstetrics & Gynecology, vol. 220, no. 4, 2019, pp. 367.e1–367.e7.