>They have tried using different
positions,  they are massaging,and can eventually get rid of them,<

I do not know what has been involved in trying different positions, but, in my
expereince, the position of the baby relative to the mother is important in that
it can facilitate the baby taking a more effective mouthful of breast tissue.
Merely moving the breastfeeding dyad around may not achieve what is needed.

Sometimes babies are on so that they look and feel on 'right', but improving the
mother-baby contact to '101%' can help.

I mention this because, after nearly a year on Lactnet, I am mildly puzzled by
how seldom positioning is mentioned.  In my practical work with women it is one
of the most common areas which need attention and in discussions with my
colleagues in the UK, it is something we discuss a lot.  Both because we still
see women coming home from hospital without having had the reasons for certain
positional techniques explained to them (they know to turn the baby toward them,
but don't know why, or that this includes removing the little arm which has
crept between the baby and theeir body), and, because , in my experience it is
always tempting to delve for interesting explanations and its hard to be really
scrupulous if positioning seems ok.

One thing I find really good to remember is that one can have thrush, or
self-doubt or bacterial infections, and these need to be addressed by the
breastfeeding worker, but that does not mean that positioning/attachment is not
also an element of what is happening.

I also find that women sometimes take some time to really believe that
differences in the way they hold the baby and offer the breast can make such a
radical difference to a problem they feel is located in another arena (e.g.
mastitis -- needs antibiotics, thrush -- needs an antifungal, not enough milk --
needs dietary changes or baby rice).  Often it can take several contacts and
some repetition of the theory behind what I am doing to get the whole thing to
gel.

What do you find?

Magda Sachs
Breastfeeding Supporter, BfN, UK

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