I have been using the analogy of sponges - including demo's of a firmer type of sponge and a softer type. I often compare doing RPS like pre-squeezing a firmer sponge before using it to mop a floor. And I also use the toothpaste in a tube analogy - you have to take the top off the toothpaste before you start squeezing - and when you squeeze the toothpaste in the middle, some goes both ways.
The straw analogy also works well when describing why it is important for a baby to use his tongue rather than gums for latching - if you bite a straw when drinking a shake, eventually the straw stays shut and no more will come. You actually have to suck "softer" to get more and take your time. Also, when you suck on a straw, you don't lean your head back and tip the cup up before sucking - you lean into the cup. This is why biological latch-on with an asymmetrical latch gets more than one concept at a time. I have noticed that when mothers lay back with the shoulders relaxed and open and well-supported, their let-down is also more controllable and handled better by babies.
And to confirm what Jean is saying here, I also do not agree with the idea of pumping before latch - makes it too difficult for babies to latch. The two-minute RPS plus hand-expression before latch is like the "Two-Buck Chuck" of the lactation world - it's cheap and it works!
-----Original Message-----
From: Lactation Information and Discussion [mailto:[log in to unmask]] On Behalf Of K. Jean Cotterman
Sent: Saturday, September 15, 2012 1:32 PM
Subject: Analogies: (Was: teat vs nipple terminology)
"Coffee stirrer versus a drinking straw"
That's a new one I'd never heard used, Laurie. Thanks. I'm really hoping more and more people share what analogies they have found helpful. Then we can all benefit from using them if they "fit" our teaching style.
I bet most everyone has felt this particular frustration before-how to use familiar terminology to sort of "sketch a picture" in the mother's mind. I think this helps her in her thinking about the breast itself, and breastfeeding process, so she can avoid using the "bottle" and "rubber nipple" familiarity she probably developed way back when she was a babysitter. This may help her resist what she hears from the picture many of her support persons might have in their minds too. If we have the chance to explain it to her significant others, so much the better to build her support system.
I remember when I was a childbirth educator and also when I was a full-time public health prenatal nurse, that I could offer a mother a breast and nipple assessment after about 32 weeks, sometimes even teaching fingertip expression. Those mothers who were interested in the assessment seemed to find an added dimension of "aha-ness" about how the areola "worked", because the learning was occuring through their kinesthetic sense. (Sadly, "learning the hard way" often chiefly involves the kinesthetic sense too.)
It's always a neat experience when I almost literally "see a lightbulb" switch on over the mother's head!!! I still think that the mother's own breast is one of the best teaching tools, if she is open to the offer of someone who is comfortable with "hands-on" teaching. (It is not necessary to "face" the mother to do hands-on teaching. In fact, I find it helps to approach from the mother's side or back so our hands approach her breast from over one of her shoulders. This also places our hands in the very same plane as the mother's hands, so she can "copy" easily. This also makes a great position to place our fingers on top of hers, to reassure her as she learns, still not "facing" her, or making her "face" us.)
I know many are not comfortable with any form of "hands-on" teaching on the breasts (even if they are perfectly comfortable with "hands-on" on numerous other parts of her anatomy;-). Also, there are many mothers who prefer verbal and written and pictorial instruction too. So all the more reason to share our verbal analogies.
Here is one that I am beginning to use more frequently: "spongy, protective tissue" (around your milk making tissues and ducts). This evolved from trying to explain to a mom who gets a lot of IV fluids, (and especially IV pit for induction, augmentation or 3rd stage management) that just as likely as ankle swelling, the first breast swelling that might slowly start might well be caused by temporary storage of some of her extra IV fluid "in the "spongy, protective etc. etc." This is a good place for anticipatory guidance on RPS, explaining that she may find it very helpful for both babe and mom "during the learning period" of the first 2 weeks.
That familiar concept of a "sponge", "around the ducts" helps overcome any possible mistaken idea that her baby would get the "stored fluid" directly from her nipple instead of her milk. It has also been very useful in explaining to moms with pendulous breasts (C cup and beyond) about lying back so gravity will help RPS effects last long enough for easier latching. It has also been helpful to explain why we do not routinely recommend the use of any kind of a pump in the first 2 weeks to our WIC moms, because the fluid stored in the "spongy protective tissue" moves too easily toward the vacuum.
OTOH, for moms who do use a pump and experience a "slowing down or stopping" of milk flow, we can use the "spongy, protective tissue" analogy to explain how a freer flow of a larger amount of milk in a shorter time can be had by moving that "stored fluid in the spongy, protective tissue" back upward in the breast temporarily by using RPS before, and several times during a 15 minute pumping period. (Plus of course, it provides a good excuse to explain the MER and to tout it's helpfulness too.)
I'm looking forward to hearing more folks share their analogies.
K. Jean Cotterman RNC-E, IBCLC
WIC Volunteer LC Dayton OH
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