We've been using LATCH at work for about four years, and frankly I'm not
thrilled with it.  You could be a chair and get a 4/10 (no pain and your
nipples are everted!).

The one good thing with our policy is that nurses are mandated to LATCH at
least one feed per shift, and to stay with the mom and help if LATCH scores
remain low.  This has been good -- unless it's crazy busy, the nurses will
really work to help the mom, and the other LC and I will get requests to
work with the mom.

In addition, the nurses are now looking to see what it is that's not right.
There's been a lot of learning instead of just "she says the kid isn't
nursing well" or "it looks ok".  Amazingly, some of the old bottlefeeding
hands will even comment, "We should talk that mom into staying., they
haven't got the hang of it yet...or we'll be seeing her in here with that
kiddo for phototherapy."  This has been a sharp learning curve!

We made the decision to go with LATCH because the vote went that way.  I
also brought in the Mulford Mother/Baby Assessment, which I thought would
assess more important factors (it was in JHL) (don't readily have
reference).  Also with my research proposal (oh rats I'm supposed to be
typing that right now) I came across Kay Matthews' IBFAT tool in JHL 9(4),
1993. It looks very intriguing and could be used by the mom on a busy unit,
with the nurse checking up after a feed to see how the mother perceived
things were going.  (I know, not always reliable! And I'd rather be right
there listening to the swallowing!)

Dawn Kersula in beautiful southern Vermont, where my kids were yelling "It's
50 degrees!" as they went off to school this morning -- usually we would
have snow!
-