With forceful MER, some moms find it helps to use a scissors (or
"V", or cigarette) hold for the first couple minutes.  This hold is
not usually recommended because it may restrict flow from the ducts
under the fingers.  However, in this case that is exactly what you
want to do.  The trick can be to do this effectively and not have
the fingers too close to the nipple where they can prevent baby from
getting an adequate latch.  Once the flow has slowed down, mom
relaxes her fingers either changing the hold or letting go
entirely.  A potential advantage to this approach, when it works, is
that you are not removing milk over and above what baby is actually
taking/needing.

Winnie

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