Written by Robin Kaplan, M.Ed., IBCLC, Owner of the San Diego Breastfeeding Center, and Co-editor of Lactation Matters
Over the past year, I have had the pleasure of listening to Catherine Watson Genna speak about the topic of an infant’s use of his/her hands while latching. I constantly share this new information with the breastfeeding mothers I work with and I have seen it completely transform a nursing session from a ‘battle of wills’ to one where the baby latches with ease and grace. Here’s hoping this information will do the same for you!
Robin: How do breastfeeding infants typically use their hands while latching?
Catherine: Babies use their hands to help them locate the nipple and define a nice mouthful of breast. You may notice the baby often finds the nipple with his hands and then starts to suck his hands. At this point, many moms
pull the baby’s hands away and he gets upset, because he knew what he was doing. If you encourage mom to wait a few minutes, the baby will move his hand and latch onto the breast where his hand was a moment before.
Robin: How does this hand use help the baby latch?
Catherine: If the baby’s face is not close enough to the breast to find the nipple by feel with her lips and cheeks, she’ll bring her hands into the action. I’ve also seen babies whose faces were close to the breast, but were not in the exact right spot to latch well, move the breast around with their hands until they got just the right ‘mouthful’ lined up. Some babies even push or pull the breast into their mouths, or shape it like we sometimes teach moms to!
Robin: What techniques should Lactation Consultants and parents use to help facilitate the baby’s hand use while latching?
Catherine: First off, I like to see what the baby will do if we place him or her skin to skin with mom and encourage mom to lean back so gravity supports baby against her body. Most babies find their way to the breast if they are calm enough. If mom has sore nipples, cuddling baby so her arms encircle and ‘hug’ the breast, and her chin and lips touch just below the nipple, lets her find the breast with her mouth and not her hands. Basically the Lactation Consultant should help the mom see how baby is working toward latching and let baby try unless they are getting frustrated or getting in their own way. Sometimes babies do get caught in a ‘reflex loop’ of sucking their hand, moving away, and then sucking their hands again. Moving the baby slightly so his face touches mom’s breast can interrupt this loop and get the baby to move his hands away and look for the breast with his mouth again.
For more detailed information about this topic, please see Catherine Watson Genna’s article in Clinical Lactation, Facilitating Autonomous Infant Hand Use During Breastfeeding.
Catherine Watson Genna has been an IBCLC in private practice in NYC since 1992. She has a special interest in the anatomical, genetic and neurological influences on infant sucking skills, and writes and speaks on these topics. She serves as associate editor of Clinical Lactation. Catherine has performed research using ultrasound and cervical auscultation to study sucking and suck:swallow coordination in infants with ankyloglossia. Her clinical photographs have been published in both lay and scholarly venues. She is the author of Supporting Sucking Skills in Breastfeeding Infants (Jones and Bartlett Publishers, 2008 and 2012) and Selecting and Using Breastfeeding Tools (Hale Publishing, 2009).
It has been so fascinating over the past 25+ years to observe the progress and better understanding of how to best assist babies to latch. Much like the medical world, it takes time to disseminate and actually use the newer understandings/observations/practices. Babies are so much better served now that we have enhanced the body of information from Chele Marmet to Christina Smillie and beyond.
What about when the baby keeps hitting the breast out of his mouth with flailing newborn coordination?
So informing! I wish I knew this when my baby was a newborn… great research!
Does this apply to preemies? My 12 week old 6 pounder usually just roots his head around (think wolf shaking its prey). Should I look for this to start?
I have noticed that this baby uses his hands a lot more than my last one did. I do have a question though. He likes to “knead” me, for lack of a better word, while nursing and it can be quite painful. He’ll actually grab handfuls of my breast. Any idea what is going on there? What should I do about it, other than pulling his hands away over and over again?