> I find myself using more circumstantial evidence like # > and quantity of poops, baby's behavior, mom's nipple comfort level, etc. > for > assessment. Does anybody else have this problem? It takes more time and skill to evaluate and correct the "in-between latch" (a latch between a really poor latch and a great nutritive latch with lots of swallows). I would say the largest majority of latches I see are the "in-between latch." Much more observance is needed and a great deal more time. Watching for swallows, looking at mom's nipple when it comes out of baby's mouth to see the shape of the nipple, and assessing the baby's behavior at the end of the feeding. I do test weights on all my assessments. This is a valuable tool. I most often know what I'm going to see when I put the baby on the scale, but it validates my assessment. There is more to assess then just if the latch looks good. Does the baby have a good latch and nursing skills or does the mother just has a delay in milk coming in or low supply? It takes time to evaluate a nursing session and much more skill then just "eye balling" a baby latched to a breast and saying it looks good and walking away. I spend at least one hour with newborns and families on first assessment. I do a great deal of teaching while observing and gathering information. Most hcps are not trained or geared to taking this much time in an assessment, most don't have this much time to take. We need more LCs and to recognize that new mothers need someone to sit with her and take this much important time to teach and fine tune her skills to instill confidence in her ability to grow in her skills with as much hands off as possible. Confidence is not built in the mother by a nurse latching the baby for her and walking away, it's built by teaching and encouraging. The best answer I know to hospitals or pediatric sittings to help support breastfeeding is to have LCs on staff and recongize that it's going to take 45-60 minutes for each assessment and maybe more than one session to really empower mothers with the confidence and knowledge they need to have a more successful breastfeeding experience. HCPs need to be trained to look for signs of early problems with the breastfeeding which includes a mother's lack of confidence or anxiety level and to promptly refer to a skilled LC. If we are going to walk the talk and promote how great breastmilk is for mother/baby, we need to also offer her the support and skills to do the job of breastfeeding her baby. I often tell these heart broken mothers that come to me after their breastfeeding problems have snowballed and they feel like failures (wonderful way to start off motherhood, NOT) that our society has failed them as a mother, they are not the failures, they are the victims. I think the best thing a hcp can be taught is refer, refer, refer to a LC who does have the skill to assess and spend the much needed time to evaluate and manage the mother/baby's feeding skills. Warm regards, Pat Lindsey, IBCLC - Lactation Services www.PatLC.com Pediatrics Plus' Staff Lactation Consultant www.pedsplus.com Orlando, FL [log in to unmask] *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html