I had mum's thumb myself, from the rugby ball hold and from texting with my thumb, so I know first hand how much it can nag. Wrist, thumb and hand pain are very common in the early months. All the lifting, holding and feeding of a newborn, together with the fluid changes of pregnancy, put a lot of strain on your hands. Two of the most common problems are mum's thumb and carpal tunnel. Both usually settle, and there is a lot you can do to ease them.

Mum's thumb

Mum's thumb, or de Quervain's tenosynovitis, is pain and swelling on the thumb side of the wrist. It comes from repetitive strain on the tendons that run to the thumb, and breastfeeding is a common cause. Holding your baby's head, supporting your breast with your thumb and fingers, and staying in the same position through long and frequent feeds all load these tendons. The rugby ball hold, with your baby tucked under your arm, is a well known culprit, as you often cradle their head with your thumb held out to the side. Scooping your baby up with your thumbs out, and everyday scrolling and texting with your thumb, all add to the strain. The pain tends to be worse when you lift, grip, or twist your wrist.

Easing mum's thumb

  • Change how you lift your baby. Scoop from underneath with flat hands and forearms, and keep your thumbs tucked in rather than sticking out.
  • During feeds, use pillows or cushions to take your baby's weight, and support your breast with a flat hand rather than gripping with your thumb.
  • Vary how you hold and feed your baby through the day, and rest your wrists when you can.
  • If the rugby ball hold strains your thumb, try a hold that does not rely on your thumb to support your baby's head, such as laid back feeding, and give your thumb a rest away from feeds too, including from scrolling and texting.
  • A thumb and wrist splint can rest the tendons. A pharmacist or physiotherapist can help you choose the right one.
  • Use cold packs to ease pain and swelling.
  • Paracetamol or ibuprofen can help, and are usually compatible with breastfeeding.

Carpal tunnel

Carpal tunnel syndrome is numbness, tingling or pain in your thumb, index and middle fingers, often worse at night. It happens when a nerve is squeezed at the wrist, and it is common in pregnancy and the early weeks because of fluid retention. It usually eases as that fluid settles.

Easing carpal tunnel

  • Wear a wrist splint, especially at night, to keep your wrist straight and take pressure off the nerve.
  • Shake or gently move your hands when they feel numb or tingly.
  • Try not to bend your wrists for long periods, including while feeding.
  • Cold packs and pain relief can help, as above.

How feeding positioning can help

A lot of wrist and thumb strain comes from how you hold your baby to feed, especially if you are hunching forward or gripping to keep them in place. Bringing your baby to the breast, using pillows or cushions to take their weight, and relaxing your shoulders and hands can protect your wrists and make feeds more comfortable for you both. Getting the latch right so your baby stays on without you gripping helps too, as in Latch and nipple pain.

When to see your GP or a physiotherapist

Speak to your GP if:

  • Your symptoms are severe, or are not improving after a few weeks of self care.
  • You have weakness, a weak grip, or you are dropping things.
  • The numbness is constant, or you notice wasting at the base of your thumb.
  • The pain is stopping you caring for your baby or sleeping.

Your GP can advise on treatment and may refer you to a hand therapist or physiotherapist. Most people improve with self care and splinting, and other treatments are available if needed.

How a consultation helps

Because I have had mum's thumb myself, it is something I keep a close eye on when I visit. I can help you find feeding positions that take the strain off your wrists and hands, using support and a good latch so you are not gripping or hunching to hold your baby. If your symptoms need more than that, I will point you towards your GP or a physiotherapist. Small changes to how you hold and lift your baby often make a real difference.