I think that some sort of hands-on can be very helpful in a class. At 
the hospital where I teach a big prenatal class, they had these 
horrible, stiff, heavy dolls,  with flexed, unbendable heads, which 
seemed especially clunky on top of a big pregnant stomach. As an 
alternative -- at the local GoodWill and Value Village thrift 
stores/second-hand stores and garage sales, one can get tons of 
practically new teddy bears -- I look for very soft, flexible, snuggly  
ones -- for $1-2 each.  I ran them through the washer, and they make 
great aids.  (I always joke "Your baby will be even cuter than this.")  
The bears are also nicely varied, colorful and multi-ethnic (and don't 
have that creepy, staring look that some dolls have --they're kind of 
friendly.)  It seems like mothers like picking out a bear from this big 
pile.

Like any tool, it's all in how the dolls/bears are used.  I show Tina 
Smillie's video, to get  across the idea of  what an active partner the 
baby is -- that we're not trying to *make* the baby breastfeed -- just 
work with their instinct to survive..   When they're holding the 
dolls/bears,  I point out that mothers are built lots of different ways, 
and it's useful to look at your body in relation to this other little 
person -- a mother with high-set little breasts has a different "fit" 
than someone with large low breasts -- and that books and videos tend to 
show pretty average (or to my way of thinking, large-breasted) people.

I tell them to think about getting themselves comfortable, and how if 
they lean back a little, they can see how gravity helps make the baby 
feel more secure, and takes more of  the baby's weight on their bodies, 
and less on their arms.  So they're leaning back, with the dolls/bears 
between their breasts.  Then I say, "And as the baby starts to twist and 
bob,  you can kind of help them in the search -- ease the bottom one 
way, and help them line where they scoop up a good mouthful."  I point 
out that babies might have more difficulty backing up, so they may need 
some help if they overshoot. If they get all fussy and upset, to bring 
them back up to soothe them and help them "re-boot" for another search.

  I point out how tempting it is to push on the back of the baby's head, 
but that if they push on the back of their own heads, they can see how 
that might hinge the chin down and bury the nose.  How the breast is a 
circle, so the baby might end up coming at the breast from lots of 
different angles, as long as the body is reasonably straight, with the 
head tipped back enough that the chin has free movement -- how it's hard 
for any of us to drink with our chins down, or turned over our 
shoulder.  How if a baby seems to be having some difficulties, one might 
try "sandwiching up" the breast a bit, or a the Rebecca Glover 
nipple-flip trick.  Such points are more graphic and memorable if we're 
involving the learner's body.

Having the class doing something active, looking at their own bodies, 
imagining the physical reality of fitting together with a baby, are 
valuable.  I like to show a lot of visuals, but some people are  
hands-on learners as well.

Good luck to all.

Margaret Wills, IBCLC Maryland

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