Dear all:

I've been forced into thinking a lot about hands lately in my post snowboarding accident state, but I had already been thinking about hands anyway.  More than any other body part, I see so much tension in women's hands when they are breastfeeding. I  know there are trends in hands off and hands on for breastfeeding assistance, but I do believe that a warm hand, strategically and confidently placed on appropriate body parts can assist in promoting relaxation.  

The touch of a hand conveys so much as I intuitively knew, but wasn't registering cognitively.  You can feel emotions through the hand:  tension, frustration, anger, timidity, and confidence.  I am right-handed -- but I have discovered through sports and breastfeeding that the polar distinctions of handedness sometimes fall apart.  
I broke the radius on my left hand and I am feeling handicapped in a way I never anticipated.  I cannot "feel" the mother properly with my right hand.  That palm on palm sensation was something ingrained that I had not realized pre accident.

We tend to focus on relaxed shoulders.  Now we have researchers recognizing what I discovered in the sit-on-a-mat-with-pillows-against-the-wall groups - that women were more comfortable in the groups because they were leaning back with their knees up, while they were sitting ramrod straight in chairs at home.  Focusing on the back or shoulders alone is not sufficient without evaluating the hands.  Tension in one can create tension in another. 

Since my physical therapist has all sorts of little gadgets that he has me use, I've been thinking about the tool I use for stressed out wrists.  I have found that a rolled receiving blanket properly placed under a mother's wrist provide far more support to enable her to relax her hand (which then leads to relaxing her shoulder -- permeating to the rest of her body) than any specialty pillow.  

I had already recommended finger stretching exercises for mothers who were experiencing tension in their hands based on my experience with jumping jacks.  Jumping jacks were making the joints in my ankles stiff --- until I did simple range of motion exercises.   For the first time in my life, I actually enjoy jumping jacks.  When a mother grabs her baby's head to lift it to the breast, her fingers often clench. So, I started applying the finger stretching for mothers with tension.  The finger strechign helps them relax enough to use the heal of their hand to hug the baby close.  I am taking a wild speculative leap that the decreased tension will also be conveyed to their babies.  

I've also noticed that my hands, which always look disproportionate to my body size, have (or in the case of the left hand -- had) much greater range of motion than most mothers I see.  I suppose I can give my piano teacher and typing teacher credit for that -- making sure I had proper positioning while using my fingers.   I'd love to know if there is research on piano playing or typing technique reduce the risk of carpal tunnel syndrome.  I'm wondering if the stresses and strains of awkward hunting and pecking on the computer versus some of the activities we used to do in the past like kneading dough may have created greater weaknesses in our hands.  I'm speculating about dough squeezing because squeezing the putty seems to release the tensions built up in my hand when it is trapped inside the brace. 

About six months ago, I finally figured out how to "feel" how expectant parents were attaching in four different positions during the prenatal breastfeeding class.  I have partners feel with the expectant mother by placing his/her palm on the back of her palm.  In this way, I can provide individualized adaptations even before the baby comes.  I know who will benefit from a rolled blanket to keep the finger from shoving the baby's head and closing the airway, who has such short fingers that they will be better off placing their whole palm on the baby's back rather than trying to wiggle their fingers around the baby's neck, etc....  I can also see all sorts of variations for breast support based on how they hold the rest of their bodies.  Some women do well with knuckles, three fingers, and the heel of their hand.  I've even seen some women who invert digits in ways that are opposite to the majority of women in ways that really seem to be much more comfortable for them.

I'm looking forward to the day when I can get back to feeling with my previously underappreciated left hand.

Best, Susan Burger, MHS, PhD, IBCLC

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