Lactation dysfunction following spinal cord injury (SCI) has been noted in the literature. However, studies often group together all women of physical disability or do not account for level of injury. The extent of lactation dysfunction in this population and impact of SCI on breastfeeding ability and behaviour is not well understood. The goal of the present study was to identify major barriers to lactation and breastfeeding related to spinal cord injury, specifically with comparison between high and low-level injuries.

Two on line questionnaires were developed and completed by women who attempted breastfeeding with SCI, primarily in Canada and Sweden.

The first questionnaire was completed by 52 women with spinal cord injury, and 38 participants completed the second questionnaire. Of the 52 women, 28 had high-level spinal cord injury (at or above T6 level) and 24 had low-level injury (below T6). Of the 78% of women with high-level injury reported insufficient milk production or ejection. Only 35% of women with low-level injury reported the same. 39% of women with high-level spinal cord injury experienced autonomic dysreflexia. Exclusive breastfeeding duration was significantly shorter (P<0.05) in the high-level injury group (3.3 months) compared to women with low-level injury (6.5 months).

Our result demonstrated that lactation and breastfeeding is disrupted in women with SCI, particularly with injury at or above T6 level which is associated with shorter breastfeeding duration. Autonomic Dysreflexia (AD) is a common breastfeeding complication that should be addressed in all-prospective mothers with high-level spinal cord injury. Our findings provide the impetus for further research into AD, therapies to improve lactation, breastfeeding aids and support required to navigate SCI-related breastfeeding difficulties. Given the immense health benefits of breastfeeding, it is imperative to provide health care professionals with evidence-based information regarding challenges for breastfeeding and lactation for mothers with SCI.