Patricia, you bring a very important (and often ignored) point about
reluctance to teach or even use side lying positions from birth.

I have trouble with acceptance of lying positions from many of my clients,
as many mothers seem to be of the opinion that they need to get a "sitting"
position down "right" before they move on to lying down and nursing.

Mothers with very large breasts may have a point, here, though, as often
their babies seem covered with breast in the first attempts to lie down an
nurse. Also, I have seen the nipples on large breasts point toward the bed,
rather than the baby, and mom needs some help to get her breast in the
right position to have it accesable to the baby. Not a difficult thing to
do, but sometimes something that may need to be introduced.

I teach these moms, and others who are reluctant to use a lying position,
to use an inexpensive "sit up pillow" (easily aquired at discount stores
like K mart and Target, these pillows look like the top part of a chair,
with arms and a nice firm back.) The moms are taught to latch on while in
their more familiar sitting position, then to "slide down" while sliding
the baby off to  the side, onto a firm, flat pillow, if neccesary. (This is
hard to explain withouth visuals, but I am sure a lot of us have done it.)
The sit up pillow can then either be removed, or the mother can lie in
the "nest" that the pillow creates, while comfortably lying down.

I had three C-Births, and started side lying and nursing in the first week
with the second baby, and the second night with the third (with the first
baby I had to have an experience of my baby starting to roll off of my lap
as I fell asleep, perched on the edge of our four poster bed to force me to
learn lying down positioning!) Many mothers already have these "sit up
pillows" and they do take a lot of pressure off of the back and arms. More
pillows can be placed under the armrest, if baby is small, or mom's arms
are weak or tired. I am too short to use standard wrap around or C shaped
nursing pillows, and these sit up pillows do not come *between* a small
mother, with short arms and her (perhaps also tiny) baby. Mothers with
large breasts appreciate the extra support the pillow gives without having
to become a "pillow architect" while trying to build a scaffold to nurse
her newborn.

It is then easy to transition from the situp pillow to a partial lying,
then to a full lying position.

I remember making little "nests" with this pillow with my last two babies.
It is one of my fondest memories of our early weeks.

Thank you all for the good discussion.

Mary Jozwiak IBCLC, RLC, LLLL, AAPL
Private Practice

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