Christine, LLL writes;
>>The mother tried to get him back on but he
wouldn't latch.  He would open his mouth but he acted like he didn't know
what to do with the breast once it was in his mouth. The nurse came in and
decided that the baby needed to get on the breast
since we had tried for about 30 minutes.  She took the baby's head in one
hand and the mother's breast in her other hand and basically smooshed the
breast into the baby's mouth.  She was pretty gentle.  Anyway in less than
15 seconds she had the baby nursing!  I felt humbled! was trying to have the
mother do all of the "work" while I
verbally guided her and helped with positioning.  Should I have been more
hands on?<<
Maybe , maybe not....It depends on the situation, Mom and/or babe's
frustration level etc.
I was intrigued when you went on to mention that you have little "hands on
experience" so most likely in your case, it wouldn't be appropriate for you
to do so.
 This isn't meant to sound derogatory in any way as I think it is great that
you recognize the need to increase your skill with this AND that you
approched the nurse in an effort to explore options to do this! You also
mentioned that you are elligible to sit for the exam and I would encourage
you to develop some more direct counseling skills, including "handson" before
doing so.
This also caused me to contemplate the idea that one could sit for the exam
without this type of skill base?
Does this concern anyone else?
There have been several posts regarding the use of "handson" techniques since
the above and it is fascinating to me that many posters assumed that the
nurse's technique was intrusive and outof line, even though the poster
describes it as "gentle". There are obviously great concerns regarding it's
use but I think Libby did a nice job in her post describing the appropriate
use of "swooshing" vs. "smooshing". Semantics makes discerning its
appropriate use via email difficult. As an example, one poster admonishes the
idea of "applying" the baby to the breast but I have heard that word used to
describe what Moms themselves do when latching the baby, in an effort to
create a distinction between placing the baby on the breast vs. placing the
breast in the baby's mouth!
Granted, I have become much less "handson" over the years but I do believe
that its use is a critical skill for one given the title IBCLC, if only just
to know when NOT to use it!
Lynn Shea Rn,Bsn,Ibclc
Franklin,Massachusetts

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