The traditional advice has been to get these young babies’ wandering hands out of the way: swaddle them down, pin them underneath a breast, smother them in cleavage, or even tangle them up in a nursing bra.
But what if those hand movements had a purpose?
Historically, they say, these movements were thought to be random and purposeless. This conclusion is partly a result of studying infant hand movements in the absence of the mother’s breast. They were also typically observed when babies were held in traditional breastfeeding positions and while being directed to latch by their mothers.
But there’s a reason for just about everything in nature, and Watson Genna and Barak say that our prior conclusions are just another way we’ve underestimated babies.
The authors say that, if left alone, babies will use their hands in various ways to breastfeed. If the baby’s face is touching the breast, babies may use their hands to push, pull, or shape the breast. If the baby’s face isn’t touching the breast, babies may use their hands to search for the nipple, or to push away “perhaps to get a look at the nipple location.”
All told, say the authors, babies may use their hands to:
- Locate the nipple
- Shape the breast
- Pull the breast into the mouth
- Self calm (by sucking on hands, and then latching on to the breast in the same location)
- Push away from the breast to look for the nipple
All this hand-to-breast touching has an additional function: raising oxytocin levels in the mother. The authors cite research from 2001 which found that when babies were held skin-to-skin with their mothers, newborns “invariably oriented to the breast and used massage–like hand movements on the mother’s breast and nipple area, which both caused increased maternal oxytocin levels and caused the nipple areolar area to become erect and more prominent to facilitate latch.”
Why didn’t we understand this before? Many of these motions look meaningless when a baby is held in a traditional hold. Once a baby is held in a laid-back position, they make a lot more sense. “Breast boxing,” as Suzanne Colson terms it, now looks like a locating and massaging set of motions.
So, how to do you use this information to help your baby latch? Watson Genna and Barak recommend starting in a semi-reclined (“laid back”) position. If this positioning isn’t possible, they recommend using a cradle hold in which the baby’s tummy is placed very close against the mother’s tummy. They note that some babies do well being placed with their heads above the nipple – they will “bop’ their way down to the breast. And they suggest placing the baby with the chin on the breast and the nipple pointing toward the space between the nose and the mouth.
But probably the biggest implication of this paper is that, when it comes to babies’ hand movements, we should mostly get out of the way.* The authors advocate not interfering with the baby’s hand movements through swaddling or pinning them down. Once moms know that things like hand sucking have a purpose, everyone can relax and let the baby’s reflexes show the way.
*For mothers with damaged nipples, the authors recommend limiting hand searching, as this can result in some painful “location” movements!