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What place and importance do these tiny little fists of fury have in the breastfeeding and optimal latch have?
Common frustration expressed by new mothers is the feeling that their new babies hands are often in the way when trying to latch their baby.
Everything is designed with purpose
Mothers are often taught to attach their baby by holding baby at back of neck, shaping the breast, then pushing baby on when a wide open mouth occurs. With this method of attachment it removes all of the baby's innate instinctive behaviour's. As a midwife and lactation consultant I am privileged to observe hundreds of newborn's and how they are born with the instinctive behaviour of touching the breast and then bringing it to their mouth and cradling the breast when attached. Babies often suck on their hands in order to soothe. When placing a newborn on their mothers chest baby's will be able to crawl to either breast with the assistance of their hands and feet to wriggle and move their body.
When studying babies behaviour at the breast it is observed that baby's use the hands in different ways to assist with attachment depending on how close a baby is to the breast. When baby's face isn't touching the breast it is observed that they use their hands as tactile searching. You will note that they use touch in order to not only see the nipple by pushing themselves away from the breast but they will also use their hands to feel the nipple in order to find it. Once touching the nipple often baby will then suck on its hand that is touching the nipple, which is a self soothing tool as well as once they move their hand often they latch in the same place the hand was. When the baby's face is touching the breast it is observed that they use the hands to push and pull the breast closer. It is also observed that they can use their hands to hold the breast and compressing it in a way that shape's the nipple to assist with a deeper latch. Please note these instinctive behaviour's are often observed when baby is uninterrupted and allowed to manoeuvre without any assistance or restraint other than the supporting arm holding baby close and supporting the head (2012, Geena & Barak).
For anyone who has breastfeed before they may remember as the baby grows they start to naturally learn how to perform breast compression to speed up the flow. I like to think of it as a little kitten kneading while feeding 🥰
How to work in harmony with mother and baby
As demonstrated the purposeful placed hands have in optimal attachment and positioning, how do we instead work in harmony to utilise this helpful instinctive behaviour.
The first important step is positioning your body in a semi reclined position to allow space for baby to be draped from your breast down with feet resting on either hip, this supports the legs and feet to allow baby to push and move the body as needed. Arrange pillows around your body and arm to create comfort first before bringing baby to the breast. This allows for full body to be supported and with bodies whole body supported by mum, pressure points on the baby are pressed to initiate reflexes for optimal attachment.
Second step is to bring baby to your breast and by using your body to support baby allows baby to be as close to your breast as possible. By bringing baby as close to your body and the breast as possible it serves multiple purposes. It allows baby to use it's face to search by turning head side to side and feeling the nipple, glands on the areola called montgomery glands secrete a scent to help newborn's find the nipple and the closeness of baby's body supports the hands to be in a cradling position around the breast.
Third step is to provide support to baby by using arm of the breast baby is attaching to, to support the body from falling by using a natural nurturing position of draped down one side and holding bum. The opposite hand is either provided extra support to keep baby close by putting pressure behind the shoulder blades. Alternatively if you have large breasts with flat nipples and baby is unable to latch without nipple shaping you can use this hand to pinch the breast on the side to provide a slight shape of the nipple to assist with latch. Ensure hands are not obstructing baby's ability to get as much breast tissue as possible.
Fourth step is patience and persistence. I completely understand the distress parents feel watching their baby become upset and distressed when trying to latch especially in the first week of life when everyone is learning. Often I have seen babies become increasingly frustrated and distressed when there is too much touching and pushing. Sometimes just long deep breaths and letting go of control and allowing the baby to use its natural reflexes can be the best latch you have. Often there is no magic trick other than skin to skin and time.
You can do this
Life isn't linear and is accompanied by many twists and turns. Breastfeeding doesn't always look like the fantasy we create in our minds or the staged picture of instagram. Don't be afraid of your feelings, your frustration, your joy, your sadness, your relief. Know that you are not alone and all you need to do is reach out to feel that connection.
Remember not one size fits all, and the most important job in the first year of your baby's life is to get to know this individual new little person and watch their journey in life.
With Love,
Candace Reynaud
Beautifully Natural Midwifery
References
Genna, C., & Barak, C. (2012). Facilitating Autonomous Infant hand Use During Breastfeeding. Clinical Lactation, 1, 15-20.
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