My 2 cents on the topic of digital exams:

Rough digital exams, forceful shoving (vs respectful assertiveness) of baby
on the breast, holding screaming babies into the breast in the hopes that
they latch on, all are abhorrent practices. But a simple situation of
allowing a baby to suck on your finger while you feel the interior and what
is going on? For goodness sake, parents have used fingers to pacify babies
for a millenia. BABIES have used their own fingers to do the same. Doctors
do their own version of suck assessment, allowing baby to suck on their
finger. And how about OTs?

I believe the key words in this discussion should be judicious and
respectful. When things are not adding up, a digital assessment can give
valuable information on what needs to be done to help mother and baby. It
certainly helps me eliminate some of the possibilities and narrow down our
focus. When done, it should be respectful, never forcing into the baby's
mouth, and trying to work with baby's cues. If a baby rejects it, so be it.

Context-- what has baby been through previously-- and current reactions are
important. If we respect baby's reactions, I do not believe harm can be
done. It is when we barge ahead aggressively that we risk creating oral
aversion. I would hope that in our profession, respecting the baby is a
primary consideration.

Given the above, I also believe that digital assessments should be learned
from experienced practioners, and not be something that someone tries
without training or mentoring.

Lisa Marasco, BA, IBCLC

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