At the risk of sounding like a broken record, nurses need a BF apgar that
is quick, easy and user friendly.  That is why I promote BREASTS by Jan
DeCoopman.  See 6 Sep 1997 of Lactnet.  Posted under assessment tools.
Plainly nurses are overworked.  LATCH has achieved a "scientific aura"
because several articles have been  published about it.

I'd love to see a research article about what nurses think about using it
and if nurses think it is helpful.  Basically I think it is time consuming,
not user friendly, complicated and really doesn't tell  us what we need to
know, beyond the fact that it is DOCUMENTED on the almighty chart that BF
has been EVALUATED.  It  puts the responsibility for evaluating on the
nurse and mom will be home tomorrow and really is the one who needs to
know how to evaluate the BFing.

Came across another in a pile of "stuff".  One page to be given to mom.  by
Pat Van Bonn and Beth Hurd. 11/91  My only comment on this one is that the
reading level is too high.  But it could be simplied easily by someone who
is familiar with literacy work.  Sincerely, Pat in SNJ

University of Michigan Lactation Program
You can assure yourself that your baby is getting enough milk by doing a
BREAST exam while your baby is nursing.

BODY ALIGNMENT  My baby's body curves right into mine.  Whatever position
we are using my baby is tummy to tummy with  me.  His hands hug my body.

RIGHT AMOUNT OF OUTPUT Once my milk supply is plentiful, usually by the end
of the first week if not before, my baby has at least 6 to 8 wet diapers a
day and 2 to 3 mustardy yellow stools.  I know this will change after the
first month to  six weeks.  I may see less frequent bowel movements [then].

ELONGATED NIPPLE  When my baby comes off the breast, for a moment, my
nipple looks almost twice its usual length.  I know she is able to get a
deep enough grasp of the breast to insure getting enough milk.

ATTACHMENT  My baby opens her mouth in a very wide yawn and keeps her
tongue down as she latches onto my breast.  Her upper and lower lips flare
outward.  Her nose, chin and cheeks are in contact with my breast.  She
pulls at least one inch of the brown areolar tissue beyond the nipple into
her mouth.

SUCK/SWALLOW  I can hear my baby swallowing.  He has bursts of suckling
activity and takes time to swallow as the milk flows.  I know my body is
producing a good supply of breastmilk.

TENDERNESS is minimal or absent.  It does not hurt to nurse my baby.  My
baby seems happy and comes off the breast by herself when she is done
feeding.  My baby looks like she is growing.

If you answer NO to any of these  statements do not be alarmed.  Your nurse
can help    you.  Tell her what your concerns are.  You may also call for a
Lactation Consultant.

Mother Baby Unit:

Pediatrics Clinic:

Community Resources:





----------
> From: kersula family <[log in to unmask]>
> To: [log in to unmask]
> Subject: Re: LATCH
> Date: Friday, December 04, 1998 8:26 AM
>
> 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!
> -