Research Review: Facilitating Autonomous Infant Hand Use During Breastfeeding

Creative Commons photo by Raphael Goetter

As the mother of two children, both who breastfed well into toddlerhood, and as a childbirth professional, I have spent a lot of time over the years 1) learning how to breastfeed or breastfeeding my children and 2) facilitating “how to breastfeed” conversations with pregnant women and their partners in my Lamaze classes, working as a birth doula with new mothers immediately after birth and in the first postpartum days at home with their newborn as well as regularly training new birth doulas and childbirth educators on how to prepare and work with their clients and students in the early days of the breastfeeding relationship.

I frequently find that new mothers often consider breastfeeding the next potential challenge after they have birthed, and getting it “right” includes avoiding pain, developing a good milk supply and making sure that their baby is getting all the nutrition they need in the vulnerable first days when things are so new and unfamiliar.  Breastfeeding challenges can increase the rockiness of an already emotionally and physically fragile time for the mother-baby dyad.

I have watched teaching methods, techniques and vocabulary change as more is learned about the newborn, their instinctive behaviors and the innate wisdom of the mothers of these new little ones.  Most of us have seen the widely viewed “Breast Crawl” video put out by UNICEF, WHO and WABA, and ooh-ed and ah-ed at the wisdom of the just born baby who self-latches when placed on its mother’s chest.   Suzanne Colson, Rebecca Glover, Christina Smillie and others have shared resources and information that has helped mothers and the professionals that support them get breastfeeding off to the best start possible, by introducing concepts such as baby led and laid back breastfeeding.

It was with great interest that I read Facilitating Autonomous Infant Hand Use During Breastfeeding and learned the important role the newborn’s hands play in helping to shape the breast, areola and nipple to facilitate breastfeeding.  I have always encouraged mothers to undress their newborn to allow for skin to skin when nursing, and sighed when I saw trained professionals encourage mothers to nurse a swaddled newborn.  But, I have to admit, I was guilty of encouraging mothers to “tuck” their baby’s hands out of the way when getting the baby to latch on, concerned that the baby’s hands would prevent a good latch as the baby seemed to want to suck on both the breast and their hand at the same time.

 In the past, the baby’s hand movements while at the breast where considered “uncoordinated,” “purposeless” and “random,” and were thought to interfere with the coordination of the breastfeeding process.  Current research shows that not to be the case at all.

Catherine Watson Genna, BS, IBCLC, RLC and Diklah Barak, BOT, the authors of Facilitating Autonomous Infant Hand Use During Breastfeeding share that babies that hug the breast with their hands are helping to stabilize their neck and shoulder girdle, by pulling together the shoulder blades. Hand movements, by the infant on the breast, increase maternal oxytocin.  It also causes the nipple tissue to become erect, which facilitates latch.  Babies are best able to use their hands “against gravity”, lifting them up, when their hands are in their field of vision.  The hands are used along with the lips and tongue to draw the nipple into the mouth, a behavior that disappears around 3-4 months of age.

The authors observed that infants use their hands to push and pull the breast to shape the breast and provide easier access to the nipple.  Newborns and young infants also use their hands to push the breast away, possibly to get a better visual sense of the location of the nipple.  Genna and Barak also state that an infant may feel the nipple with their hand, and use the hand as a guide to bring their mouth to the nipple.

 Wonderful black and white pictures accompany this article, and useful video clips are included for great visuals of the behaviors described by the authors.  The authors provide information on how to facilitate infant hand use during the breastfeeding session, including step-by-step instructions that can be shared with expectant and new mothers when you are teaching.

 Teaching new mothers that their newborn’s hands are a tool that the baby uses to find and latch on to the nipple, rather than something to be restrained and held out of the way, can help new mothers to appreciate the innate abilities of their newborn to self-latch and breastfeed successfully.  The materials in this article can be incorporated in the curriculum you cover when you discuss breastfeeding, and increase confidence and success for the new mother and encourage the breastfeeding relationship to have the best start possible.

 Please take a few minutes to follow the link and read the article, view the pictures and videos and let me know how you envision using this information in future classes?  Have you changed how you teach breastfeeding as new concepts and information have become available?  Share your tips and success stories with us, so that we all can become more skilled at providing new parents with effective teaching practices that support the breastfeeding relationship.  I look forward to hearing from you.


Genna, C.W. & Barak, D.  Facilitating autonomous infant hand use during breastfeeding.  Clin Lact 2010; 1(1):15-20.





Babies, Breastfeeding, Continuing Education, Doula Care, Evidence Based Medicine, Healthy Birth Practices, Infant Attachment, New Research, Newborns, Parenting an Infant, Practice Guidelines, Research , , , , , , , , , , , , , , ,

  1. avatar
    | #1

    This is fantastic! It all makes total sense and I am so glad this is to be true! Very informative. I look forward to helping new mothers with these new breastfeeding tips!!

  2. avatar
    | #2

    This makes so much sense. Wish I had this information when I was nursing my babies. So now, what do you do if the baby wants to suck on hand and nipple together?

  3. | #3

    @Lara According to the authors, the baby may self-sooth by sucking on their hand and then will move the hand out of the way and attach. Here is the link from one of the videos in the journal article, that may speak to that. http://media.clinicallactation.org/fall10/videob.mp4

  4. | #4

    How interesting! My baby alternated between hand and breast, and I never considered whether or not it had a purpose. Even now at 15 months, he alternates between breast and whatever toy he has brought to my lap.

  5. avatar
    | #5

    My 3.5 month old like to suck his thumb while he is breastfeeding. He shoves his thumb into his mouth while he’s still latched on, which breaks his latch…? He is growing and developing and has plenty of energy so it doesn’t seem to be interfering with his ability to suck or swallow.

  6. | #6

    Thanks for sharing this. Very interesting article…

  7. avatar
    | #7

    It’s interesting to read something that I have already experienced. I had hyperlacation issues and even from birth my daughter would push my chest away when it was too much for her. She has always held my hand and/or breast whenever she eats. She is now about 4.5 months old.

  8. avatar
    | #8

    I’ve told my husband this since m daughter was born, now 9 months. She pushes the breast back to lath and smacks my breast with her hands which I always thought was her way of getting letdown to hurry up. And she still hugs while she nurses.

  9. avatar
    Elly Egenberg
    | #9

    I witnessed a newborn smack and knead and pinch her mothers inverted nipple until that nipple complied with her wishes and protruded. Very awe inspiring.

  1. | #1

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