I agree with Kathleen A. It behooves us all to constantly look at our practices to evaluate effectiveness. I just finished teaching the UCLA Lactation Educator class in Los Angeles. During my introduction , I stated that many of the techniques and trueisms I learned about breastfeeding thirteen years ago have changed. For instance, assisting attachment on the breast, length of feeds, frequency of feeds, and use of nipple shields. We must always try to review the literature and to question how we approach the maternal/child dyad. I also mention that many of the lecturers will differ in their approach to breastfeeding. I encourage them to listen and then to question. If they don't agree, go back to the literature look for articles that support their own approach and then evaluate the effectiveness when working with their clients. Some of what we learn and teach in breastfeeding is not research based. We must be cautious about quoting practices as though they are the gospel. If we can keep an open mind, the profession of Lactation Specialty can only improve. Off my soap box for now. Andrea Herron R.N., M.N.