Carpal tunnel syndrome in breastfeeding mothers

July 27, 2011. Posted in: BF Concerns: Mother

by Kelly Bonyata, IBCLC

Carpal tunnel syndrome can sometimes appear during pregnancy or postpartum. Carpal tunnel syndrome associated with pregnancy is thought to be related to inflammation and edema of the median nerve as it passes through the wrist. It can take a few weeks to a few months after delivery for the symptoms to resolve but it usually clears up completely.

Several cases of carpal tunnel syndrome in breastfeeding mothers have also been reported in the literature. In these cases, the carpal tunnel syndrome began within a month of birth and only completely resolved after weaning. Carpal tunnel syndrome has also been reported postpartum in non-breastfeeding mothers. In the three non-breastfeeding mothers who were studied, the symptoms were less severe and resolved within a month.

It is possible that carpal tunnel syndrome in breastfeeding mothers may be related to or aggravated by repetitive motions and/or excessively flexed wrist positions during breastfeeding. A similar syndrome, deQuervains tendinitis, has been noted in mothers with babies 6-12 months old and is attributed to repeated lifting of an increasingly heavy baby.

Per WebMD, “excessive repetitive movements of the arms, wrists or hands can aggravate the carpal tunnel.” The ideal position for your wrist to be in is a neutral position, rather than bent back or forward. Carpal tunnel syndrome is made worse by bending the wrist, especially if the bending is sustained over time.

Tips for breastfeeding mothers with carpal tunnel syndrome

  • Pay attention to positioning. Are you curving your hand and wrist around your baby to support and cuddle him/her? Look for ways to support your infant that don’t involve a bent wrist. Bed pillows, special breastfeeding pillows, rolled/folded baby blankets (particularly under the wrists) can all allow mom to hold baby without bending the wrist excessively. A footstool may also help with positioning baby in your lap.
  • Use a baby sling to support baby.
  • Breastfeed lying down, continuing to pay attention to wrist position.
  • Use a specially designed wrist brace to keep your wrist in the neutral position while breastfeeding. Sleeping with the brace on can be especially helpful.
  • Some say that the cross cradle hold (particularly long-term use) may cause or aggravate carpal tunnel syndrome, as baby’s weight is often supported by the hand in this positioning.
The recommended treatment for carpal tunnel syndrome is conservative, with rest, diuretics, hand splint, and local corticosteroid injection, because it is usually reversible. No women had residual signs or symptoms, so perseverance with lactation and symptomatic treatment is appropriate.

— Lawrence & Lawrence, in Breastfeeding: A Guide for the Medical Profession, 5th ed. St. Louis: Mosby, 1999, p. 533.

Treatments have proven helpful for carpal tunnel syndrome

  • Resting the affected hand and wrist, avoiding activities that aggravate symptoms
  • Immobilizing the wrist in a splint
  • Stretching and strengthening exercises, massage
  • Use of cold compresses (if inflammation is present)
  • Nonsteroidal anti-inflammatory drugs such as ibuprofen
  • Diuretics (“water pills”)
  • Steroid injections (these are compatible with breastfeeding)
  • Vitamin B6 (pyridoxine) supplements
  • Yoga and other relaxation techniques
  • Use of electrical stimulation (TENS unit, etc.)
  • Acupuncture
  • Chiropractic care
  • Surgery

 

General information (not breastfeeding related)

Carpal Tunnel Syndrome from MedlinePlus and the National Institutes of Health

Carpal Tunnel Syndrome During Pregnancy by William Hagberg, MD

Pregnancy Induced Carpal Tunnel Syndrome from Midwifery Today E-News (Vol 1 Issue 47, Nov 19, 1999)

deQuervain’s Disease from WebMD & The Cleveland Clinic Department of Rheumatic and Immunologic Diseases

deQuervain’s Tendinitis from the American Academy of Orthopaedic Surgeons

References

Mohrbacher N, Stock J. The Breastfeeding Answer Book, Third Revised Ed. Schaumburg, Illinois: La Leche League International, 2003, p. 534.

Siebenaler N. Maternal Physical Impairments. In: Walker M, ed. Core Curriculum for Lactation Consultant Practice. Boston: Jones and Bartlett, 2002, p. 248.

Lawrence R, Lawrence R. Breastfeeding: A Guide for the Medical Profession, 5th ed. St. Louis: Mosby, 1999, p. 532-533.

Wand JS. Carpal tunnel syndrome in pregnancy and lactation. J Hand Surg [Br]. 1990 Feb;15(1):93-5.

Wand JS. The natural history of carpal tunnel syndrome in lactation. J R Soc Med. 1989 Jun;82(6):349-50.

Yagnik PM. Carpal tunnel syndrome in nursing mothers. South Med J. 1987 Nov;80(11):1468. Reports two cases of carpal tunnel syndrome in breastfeeding mothers where symptoms developed one month postpartum and subsided after weaning.

Snell NJ, Coysh HL, Snell BJ. Carpal tunnel syndrome presenting in the puerperium. Practitioner. 1980 Feb;224(1340):191-3. Reports five cases of carpal tunnel syndrome in breastfeeding mothers where symptoms improved with temporary weaning and subsided within a month of complete weaning.

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