The 'cigarette' or scissor hold can be used to pinch off some of the 
flow during MER.  The mother holds her first two fingers in a V shape 
and scissors them down on or behind the base of the areola as the MER 
is coming on, or during it.  It should be released as soon as the MER 
tapers off.

Use of this hold is generally frowned upon precisely *because* it can 
impede the flow of milk.  In the case of OAMER, though, that's what 
you want.  It would be wise to explain to the mother why it shouldn't 
be used all the time, only when it is needed.

Margaret
Longmont, CO

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