Hi Lactnuts,

A cautionary note about the 'Australian hold ' (mom supine, baby
prone).  Our Australian sisters at the ILCA conference noted that
this hold fell out of favor in Australia over 8 years ago due to some
unfortunate sequelae.  Seems that in the supine position the milk
sinuses recede into the breast and are out of reach for most babies,
so the breasts are not well-drained, resulting in dwindling milk
supply, slow growth, etc.

As with many of our interventions, it seems we should be stressing
the *temporary* nature of our suggestions to moms.  Once the
presenting problem (sore nipples due to babe keeping tongue back,
hyperlactation or overactive letdown) is resolved (baby's tongue
covering lower gum, baby nursing more comfortably at breast) moms
should be encouraged to gradually resume more typical nursing
positions that ensure good breast drainage.  I'd suggest
transitioning from the Australian hold to a football (clutch) hold in
a semi-reclined position, and then gradually have mom work her way up
to sitting upright as she and baby gain confidence in their skills.

Terry

Terry Dalton Hadley, RNC, IBCLC
Towson, MD