Hi Ho Fellow Lactnetters,
  At the risk of offending someone I think the world of, I feel the need to
express some concern or at least a word of caution about a technique I have
heard that our wonderful Dr Jack (troubadour of breastfeeding and friend
indeed:)) advocates.  That is breast compression.  I think it might be
overused or used incorrectly and I offer a word of observation and caution
about it.  I have not personally heard Dr Jack speak (my loss, I know) but I
work in a hospital with an LE who was telling me about it and is very
enthusiastic about it.  I have on several occasions worked with patients after
she has seen them and heard several remarks that concerned me.  One mother of
a premie had a sore breast where she said the LE had "really squished it" the
day before.  One mother was frustrated to the point of tears because she said
the staff were just latching the baby on for her, and not showing her how or
helping her to.  Many patients speak of the "breast sandwich" the LE referred
to and talk, if not unhappily, more like somewhat taken aback (is that too old
a phrase:)), at how aggressive this LE is in manipulating their breast.
Personally, I see a couple of problems here.  One: if we're "putting the baby
on the breast for them, how does that help them when we aren't there?
Second: inasmuch as we ask permission to enter a baby's mouth with our finger
etc. we should be asking permission to touch the mother's breast.  They will
at least not feel manhandled or "violated".  They may even refuse.  But, they
should be given a choice.   I have never had a mother refuse, but I wouldn't
dream of touching without asking first.  It seems a matter of respect IMHO.
Third: I can see tissue damage, however mild, resulting from rough
manipulation of the breast.  We surely don't want to complicate things.
   There are times when I do use some manipulation to get a baby latched on
appropriately.  Sometimes there is no other way, but we should ask permission
and respect the patient and her body while we try to do what's best for mom
and baby.
  Since I haven't heard Dr Jack's instructions en total, perhaps this LE is
misusing this approach, but it wouldn't hurt to be more cautious in advocating
or explaining it.
Marsha Puckett RN, IBCLC
from not so sunny, in fact, down-right cold, Indpls, IN