After being off Lactnet for a whole week to attend an international
midwives' congress in Vienna, I have just read through nearly the entire
archives for the time I was no mail (whew!), and have to jump in on the
plugged duct thread.
I second Denise Fisher's thought, that there is no One Right Answer, and
given the variation in anatomy demonstrated by Hartmann it seems wise to try
different approaches until one of them works.
Here I will put in a word for the Lazy Woman's technique which in Norway is
credited to me.  If the plugged duct is in the upper outer quadrant of the
breast it is a handy technique to know.  Mother lies on side *opposite* the
breast with the plugged duct and feeds from the affected breast.  This means
the breast will be hanging down in a free fall to the baby, and I imagine
the ducts may be straighter than in many other positions.  Whatever the
reason, it seems to work, and mother gets to lie down to do it.
BTW, there were no formula manufacturers among the commercial exhibitors at
the congress.  The International Confederation of Midwives has a resolution
against that.  But the pacifier folks were EXTREMELY high profile, both Nuk
and Mam.  There were quite a number of stands supplying all manner of
paraphernalia for the breastfeeding mother, most of which were harmless at
best, in the way at worst.  But the pacifier stands were incredible, and the
heavy-duty paper shopping bags they tried to foist off on everyone with all
their samples of everything were an annoyance during lecture sessions as
they didn't merely rustle, they issued reports like 21-gun salutes when
picked up or set down or bumped into.
I chaired two sessions, including the only one at which non-midwives
presented anything.  Opened it by saying it would be a participant-friendly
session and pacifier bags could be left at the door to keep the noise down.
The non-midwives were Anne-Marie Kern, an IBCLC (and Lactnetter) from
Austria, with a series of slides showing how BF is depicted in art,
religion, mythology and advertising, 20 minutes of dynamite with her
excellent, thought-provoking comments, and Ilse Bichler from IBCLE, who
spoke about the credential and the exam.  What a privilege to meet them
both, and how proud I was to be an IBCLC in such company!  We walked around
with our blue or gold ribbons attached to our name badges, supplied by
IBCLE, and got to tell a lot more people what IBCLCs are, as well as find
the others easily.  Ribbons are really a good idea for conferences where the
primary focus is not lactation/BF but where there are many IBCLCs in the
crowd.
It was also encouraging to see that there were more abstracts than ever
before about breastfeeding, and the sessions in which they were presented,
were well-attended, with animated discussions after the presenters were
finished, even at the end of our long days filled with so much information
we could barely digest it all.
cheers
Rachel Myr
Kristiansand, Norway

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