> In looking back over the years I've been working with breastfeeding moms
> and babies I think I went from "hands off" to "hands on" and hopefully
> am now somewhere in the middle.

Same here. I have found it very efficient to first take her baby and
demonstrate on myself both positioning and mom's role in latching,
describing each significant step as I do it and why each point is important.

Then I give baby to the significant other to hand to mom, pointing out to
this person what an effective position looks like from our side, while
reinforcing to mom what she's feeling from her side, and then guiding her
hands with mine as needed. Once baby is latched on, I slide my hands out,
leaving only mom's hands in correct places. This means I need to be/stand
behind her ideally, but I can adapt my position if she is in her (hospital)
bed. I teach the "finish the first breast first" and use the time until baby
unlatches itself to continue to teach - pointing out things like adequate
breathing space (listen for breathing) and signs of swallowing.

In about 10 or 15 minutes, when baby slips off the breast, I teach burping
and changing. With baby more awake, I have mom talk through the latch-on
first before trying it with the second breast. Usually, I need only make
verbal corrections and she's right there with me. Sometimes I'll guide her
hands again. Thus I use a combination of hands-on hands-off until she knows
what it feels like. It seems to work well.

Katharine West, MPH, MSN, RN
Sherman Oaks, CA

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