Kimberly asks if anyone has used the LATCH assessment of a breastfeed tool
described in JOGNN in 1994.  I implemented the use of this tool in the
hospital I was working in and it has been in use now for 18 months.  I
changed one of the reference points to read 'nipple type immediately after
detachment' so that an inverted nipple which had been everted during a feed,
but 'popped' back in again afterwards would still score a 2.
The advantages I found with it were that the midwives would take that little
bit more time explaining good attachment and what to look for as the baby
feeds, and it made a useful 'handover' tool for the next shift.  They were
supposed to check one feed every shift and every feed if the score was 7 or
less.  I found the mothers liked it too.
One midwife complained that we were rating everyone and felt it was
threatening.  The biggest problem I found was that when we were busy, which
was most times, that it wouldn't be done.
Hope this is useful Kimberly
Denise Fisher
Brisbane, Australia