http://media.clinicallactation.org/fall10/CLGenna.pdf
If you are a breastfeeding mom like me, you probably have scratch marks, at various stages of healing, across your chest. Well, a few weeks ago, I was surfing the Internet and came across an interesting article titled, “Facilitating Autonomous Infant Hand Use During Breastfeeding” by Genna and Barak (see this link for the full article: http://media.clinicallactation.org/fall10/CLGenna.pdf). Apparently, those seemingly random hand movements your baby engages in while nursing are not so random after all! I attended a lactation consultation class three years ago where I was taught to tuck my baby’s hand between my arm and body so his hands would not “get in the way of a good latch.” In this article, Genna and Barak review literature that suggests infants begin the process of developing deliberate, goal-directed
If you are a breastfeeding mom like me, you probably have scratch marks, at various stages of healing, across your chest. Well, a few weeks ago, I was surfing the Internet and came across an interesting article titled, “Facilitating Autonomous Infant Hand Use During Breastfeeding” by Genna and Barak (see this link for the full article: http://media.clinicallactation.org/fall10/CLGenna.pdf). Apparently, those seemingly random hand movements your baby engages in while nursing are not so random after all! I attended a lactation consultation class three years ago where I was taught to tuck my baby’s hand between my arm and body so his hands would not “get in the way of a good latch.” In this article, Genna and Barak review literature that suggests infants begin the process of developing deliberate, goal-directed
(albeit uncoordinated) hand-mouth movements in utero in the following sequence: mouth opens, arm moves, hand touches face or mouth before swallowing amniotic fluid. After birth, babies use their sense of sight to lift and guide their hands to the breast, in spite of gravity. Newborns use their hands to shape and draw the nipple into the mouth to facilitate latch and to massage the breast stimulating the ducts to release milk. Genna and Barak found that when an infant’s face is touching the breast, the baby may push or pull the breast to bring the nipple to the mouth or stimulate the nipple to become more erect for an easier latch. If the infant’s face is not touching the breast, the baby may push away to get a better look at the mother’s nipple or use the hands to find the nipple. When the hand finds the nipple, the baby may mouth the hand, as a self-calming behavior, before removing the hand and latching on at the same spot. In sum, mothers can trust that their babies, if given the time, can and will use their hands to “identify, move, and shape the nipple area.” Babies who use their hands to search for the nipple may often suck on the hand to self-soothe prior to removing the hand and latching on to the nipple. This is a natural step in the process that does not need to be restricted or rushed. For mothers with sore or damaged nipples, ensuring baby’s face is touching the breast will increase oral searching and decrease tactile searching (i.e. pinching or squeezing).
Based on these findings, the researchers recommend mothers take advantage of these skillful hand movements while breastfeeding. They advise mothers lie in a semi-reclined position, fully supporting baby’s body and weight. In this laidback position, mothers can bring the infant’s unobstructed arms around the breast so the arms are in the infant’s line of sight. To get baby’s mouth to open up wide, they recommend baby’s chin touch mother’s areola while baby’s philtrum (the space between the upper lip and nose) touch the nipple. Nevertheless, every infant is different; some may prefer to begin the process with their cheek touching the breast above the areola or self-initiate attachment from the mother’s chest or shoulder.
As a psychologist, with strong ties to attachment theory, I loved this article because it reinforces the autonomy and interdependence of the mother-infant dyad. Post-partum can be a period when a mother tries to control as much as possible to ensure the safety and survival of her vulnerable infant. This can be a foreclosed perspective as absolute control is not only illusory and impossible, but it does not take into account what an infant brings to the relationship. Even a newborn baby has boundaries that should be honored and respected. By tucking away my baby’s arm to “get it out of the way because I know best,” I am not saying that I caused permanent, irreversible damage (thankfully, kids are resilient!), but, unfortunately, I may have communicated distrust in an ability that was well within his scope of competence. After all, he had been practicing this skill specifically for weeks before making his official appearance! Reading this article has definitely caused me to stop and reflect on the ways I am modeling mutual trust both as a parent and a therapist. In what ways am I impeding the natural process of development? And how can I actively communicate trust and support the facilitation and practice of ever-expanding skills in my children and clients?
Based on these findings, the researchers recommend mothers take advantage of these skillful hand movements while breastfeeding. They advise mothers lie in a semi-reclined position, fully supporting baby’s body and weight. In this laidback position, mothers can bring the infant’s unobstructed arms around the breast so the arms are in the infant’s line of sight. To get baby’s mouth to open up wide, they recommend baby’s chin touch mother’s areola while baby’s philtrum (the space between the upper lip and nose) touch the nipple. Nevertheless, every infant is different; some may prefer to begin the process with their cheek touching the breast above the areola or self-initiate attachment from the mother’s chest or shoulder.
As a psychologist, with strong ties to attachment theory, I loved this article because it reinforces the autonomy and interdependence of the mother-infant dyad. Post-partum can be a period when a mother tries to control as much as possible to ensure the safety and survival of her vulnerable infant. This can be a foreclosed perspective as absolute control is not only illusory and impossible, but it does not take into account what an infant brings to the relationship. Even a newborn baby has boundaries that should be honored and respected. By tucking away my baby’s arm to “get it out of the way because I know best,” I am not saying that I caused permanent, irreversible damage (thankfully, kids are resilient!), but, unfortunately, I may have communicated distrust in an ability that was well within his scope of competence. After all, he had been practicing this skill specifically for weeks before making his official appearance! Reading this article has definitely caused me to stop and reflect on the ways I am modeling mutual trust both as a parent and a therapist. In what ways am I impeding the natural process of development? And how can I actively communicate trust and support the facilitation and practice of ever-expanding skills in my children and clients?
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