The effect of lateral asymmetries on breast feeding skills: can midwives' holding interventions overcome unilateral breast feeding problems

Abstract

Objective: to determine whether the three human lateral asymmetrical behaviours (maternal handedness, maternal preferred cradling side, neonatal preferred head turning) affected the development of a unilateral breast feeding problem (UBP). Design: quasi-experimental comparing 32 postnatal women who reported a UBP with 28 who did not. Setting: maternity unit in the south of England. Participants: 60 mother/baby pairs where it was the mother's first attempt at breast feeding, there were no structural abnormalities of the breasts or nipples, no obstetric abnormalities, and where the mother had had no more than 100 mg pethidine in labour. The babies had to be less than 72 hours old at recruitment, show no abnormal behaviour, such as floppiness or irritability, and weighed 2500 g or more. Measurements and findings: handedness test, preferred cradling side established, neonatal preferred head turning established, demographic data. The two groups of women did not differ on demographic characteristics, but multiparous women were less likely to report a UBP or a neonatal preferred feeding side and more likely to be feeding at six weeks post delivery. Neither dominant handedness nor maternal preferred holding side alone were associated with a UBP but when the dominant hand was different from the preferred holding side, the women were more likely to have a problem side and to report a preferred feeding side. A neonatal head turning preference was associated with a UBP but not with success/failure of breast feeding at six weeks post-delivery. There were no associations between the holding interventions used by midwives and the successful continuation of breast feeding until six weeks post-delivery. Key conclusions: there is no conclusive evidence associating the management of a UBP with differing intervention holds. Implications for practice: there is a need of further research to select the most appropriate intervention to help an individual mother and baby.