There was a ? asked about how I taught Assymetrical latch and 
S2S sorry don't remember who asked. Haven't had time to 
answer e-mails for a few days. I do not use the words 
Assymetrical latch with patients. The patient I described had a  
baby that wouldn't latch  at all and never had. If a a baby is 
latching and transferring without difficulty I don't fix what is not 
broken. I do very little phone teaching, what I see is so often 
very different from what is described. The patient I described 
was not able to see an LC for several days so  I tried to give 
just basic latch info.  I have them use breast 
compression "breast sandwich" "U" hold for cradle and "C" for 
football.Bring baby close to the breast, support the head and 
neck and shoulders  with the hand,fingers around the ears not 
on cheeks. Let the baby tip head back just as we do to drink 
and let the chin touch the breast first. If the baby isn't opening 
mouth wide stroke from under the nose to the chin with the 
nipple. Take advantage of the infant's great sense of smell and 
have breastmilk on the nipple and   the areola prior to latch. No 
forcing, no pushing the back of the head letting the baby latch. 
Just very basic stuff I think.
 For S2S I like to let a baby start out on the abdomen when  
they are just born but I don't usually see them until they are at 
least 4-5 days old. I work in home care and they are usually 
seen by a maternal child nurse first, i am called if they still have 
difficulty. I have enough trouble getting most patients to try just 
having the baby  on their chest with baby in just a diaper with a 
blanket around. Many think this is a little crazy. I tell them to 
put the baby between their breasts or even just resting on  the 
center of their chest with the head to the side. Let the baby 
sleep and rest there and the baby can decide to self latch if 
they are ready and  at times only half awake. If they are willing 
to use prolonged S2S I tell them about Nils Bergman's shirts 
that allow for safe prolonged S2S. i am open to any 
suggestions. Chris Erland RN IBCLC

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