Dr. Parrilla and I were discussing the Lactnet dialog and she had two
suggestions to pass on:

1. We could use "latch-on difficulties" which is less threatening and actually
better describes the problem observed.

2. She finds that teaching the parents to use the oft-maligned
"orthodontic-type" nipple upside down (holes pointing down) and with the baby's
lips way in - touching the base of the nipple, she is better able to get babies
to take to the breast again.

Bottles are so prevalent here that telling parents not to use bottles usually
means they won't call because they're embarrassed - or they'll not admit it.
She gives them "permission" to use them as a last resort, but with the above
instructions, and has less problems than with any other nipple.

Jeanette Panchula, BSW, LLLL, IBCLC, RN
Puerto Rico
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