I have been following this thread with interest.  I think we have
learned more and more over recent years about how babies feed
effectively and how the breast can be drained effectively.  In my 25 
years of working with mothers and babies, I definitely see less problems
with a mother/baby pair learning to breastfeed via  an asymmetrical
latch from the transitional hold.  It is almost "fail proof".  The
newborn has very little muscle tone and therefore needs to be held
firmly into his mother to feed effectively.  Once the baby is a little
bigger and stronger, they will adjust their bodies themselves for
optimal feeding.
 
If you watch children play at feeding babies, they certainly hold
dolls/babies differently from what adults do.  Where does instinct and
where does influence begin and end?  
 
We all know that new mothers need consistent advice (as inconsistent
advice is often quoted as the reason for losing confidence with
breastfeeding) so therefore I find it beneficial to teach staff a
consistent technique with positioning and latching so that they can be
consistent with the mothers they work with.  With early discharge froml
hospital and birthing units, our messages need to be clear, consistent
and achievable!
 
That does not mean that other styles cannot work really well for some
mother and baby pairs, but they are not usually the ones who need our
extra imput.
 
The challenge is to help mothers adjust their techniques and styles as
the baby grows and matures.  That is where community support networks
come in.
 
On a personal note, I taught myself the asymmetrical technique with a
transitional hold (not that we used those words then) with my first baby
22 years ago (as it seemed instinctive at the time) and I can honestly
say through 4 children I would not know what a sore nipple was!  Was I
lucky or did I stumble across something really workable?
 
Just my thoughts...
 
Karen Palmer
Midwife and IBCLC, New Zealand
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