MoreThanReflexes.org provides professional education on sensory-perceptual-motor learning, motor forgetting (skill decay), and motor relearning, in support of robust motor memory for the earliest of infant milk-feeding skills. Toward this goal, many precepts are integrated from the fields of breastfeeding science, developmental psychology, developmental cognitive neuroscience, and kinesiology – the study of human movement, motor learning, and motor control.

As baby mammals, we receive early learning support for milk-feeding skills in the form of pre-adapted movements termed the primitive survival reflexes (crawl, search/rooting, oral grasp or latch, suck, swallow, and cough), but the exquisite presence of these reflexes does not guarantee the oral grasp and effective suckling for all infant milk-feeding methods all the time.

There is a widely known but poorly understood universal phenomenon of observable infant breastfeeding difficulties that often follow the use of an artificial nipple, and a wealth of data correlates the use of an artificial nipple with shorter duration of exclusive breastfeeding, as well as early termination of the entire breastfeeding course. Similarly, bottle-fed infants are frequently observed to struggle with - and often refuse - a novel style of artificial nipple, regardless of whether the bottled milk contains expressed mother's milk, human donor milk, artificial infant milk, or a blend of any of these milks.

Infant breastfeeding difficulties that follow the use of an artificial nipple are often observed as a recency effect, i.e., the primitive reflexes are often more heavily weighted toward the more recently learned feeding method, rather than equal weighting of these reflexive feeding movements for all infant milk-feeding methods all the time. A further aspect of the phenomenon is that infant breastfeeding difficulties are less likely to occur when the use of an artificial nipple is avoided entirely or for a sustained period of time, particularly during the early learning period for breastfeeding skill acquisition, when early motor memories are at their most fragile.

Similarly, there are other fragile aspects of early memories, such as the early learning of a new computer password or a new telephone number. It is the rare individual who can build robust memory for a new computer password by using that numerical sequences only once. Repetition of task-specific practice is a critical aspect in building robust memory.

Motor learning is a complex process across the lifespan, and learning how to switch between tasks that are similar yet different (task-switching) is also a time-consuming process as we learn how to discern and differentiate between movements that are appropriate as well as inappropriate for performing various tasks.

Exclusively bottle-fed infants often display greater skill with an artificial nipple that was most recently learned, and bottle-fed infants often refuse a novel artificial nipple that is different in size, contour, and/or length. When babies have learned to breastfeed as well as bottle-feed, parents often report that their infant will only accept a certain style of bottle nipple. When babies and children are given pacifiers (soothers), there are often observable displays of refusal for a different style of pacifier, as well as displays of acceptance for a previously learned style of pacifier.

Although lactation consultants are extensively educated and trained in breastfeeding and lactation management, much of the clinician’s workday is spent providing verbal, visual, and manual guidance to parents in motor learning for positioning the baby to feed. Manual guidance is also provided to the baby for learning how to perform the oral grasp of the nipple-areolar complex (the latch), as well as manual guidance to the infant in learning how to effectively suckle for adequate transfer of milk.

Like other professionals who provide hands-on care, lactation consultants are not born knowing how to provide such assistance. As we progress from the novice stage to increasingly greater expertise in the acquisition of our clinical skills, we each have our own sensory-perceptual-motor learning curve toward increasingly greater motor control, achieved with the repetition of practice.

To date, precepts from the fields of motor learning, developmental psychology, and cognitive neuroscience have been little discussed in the field of breastfeeding and human lactation. Similarly, the fields of developmental psychology, cognitive neuroscience, and kinesiology have placed little to no focus on the acquisition, skill decay, and reacquisition of infant milk-feeding skills. Integrating precepts from these related sciences can offer greater many insights into the acquisition of our earliest of skills.


MoreThanReflexes.org is a professional educational website by Debra Swank, RN BSN IBCLC.  Ms. Swank is a graduate of Davis & Elkins College, and began her health care career serving infants, children, and young adults with genetic and other chronic health problems.  An International Board Certified Lactation Consultant (IBCLC) since 1998, Ms. Swank has provided care in both rural and large urban settings to over 15,000 nursing families from many walks of life.  In addition to her professional interests in sensory-perceptual-motor learning for the acquisition of infant breastfeeding skills, Ms. Swank is also interested in the science of human milk, Tronick's Mutual Regulation Model (MRM), and the life work of Abraham Maslow.