Dear Rachel,
I think what you are seeing is often instinctual with a lot of moms, no matter what kind of "hold" they are using or have been taught. They are trying to push as much of the breast as possible into the baby's mouth, but as you note, it is often more skin than ductal tissue. This goes back to bringing the baby to breast rather than vice versa. I mostly suggest the football or cross-cradle with new moms and find that a variation of the c-hold usually does work best. But sometimes a mom will persist with some type of scissor hold and if she seems much more comfortable with this, then I try to make sure that it does not lead to some of the problems that you refer to. Preventable nipple soreness and trauma is a great frustration for the LC to watch develop and then have to try to alleviate, so I do appreciate where you are coming from here. What is really frustrating is to get a baby latching well, and then come back later to see the mom has reverted to her previously inadequate positioning with predictable results. Sometimes you have to come up with a compromise which mom finds comfortable or "normal" and still allows for a good latch - not always an easy task. Some of this has to do with how much time you have to spend with mom. During a long, private consult I can really work with her to find the optimal approach. In the hospital, time is very limited and moms are not always receptive to our suggestions, especially if grandma is telling them that the LC doesn't know what she is talking about. Most moms, however, are very happy to see and feel the difference when the baby is at breast correctly.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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