Re: recent exchange here on Lactnet about "What 3 things would an LC
choose to include if given the opportunity to make up a 3-point packet to
give to all OB-Gyns in her facility:

<>> Evidence doesn't support prenatal nipple exams as being all that
helpful.<<

<I agree! And even if they were, I'm not sure that a "nipple diagnosis"
by an
OB would translate well into practice as they typically don't get very
involved with the practical aspects of breastfeeding.>

I think there is room for disagreement here. As to "evidence", I think
the conclusions drawn are very wide and faulty for making a blanket
decision to virtually ignore taking any clues from nipples observed
prenatally.

I think there is value in the opportunity to reassure 95% of mothers and
at least for the remaining 5%, prenatal referral. Specialized teaching
and advanced planning for management of the initiation of lactation can
be of tremendous help in certain situations with potential for problems.

A mother may get into unnecessary problems if she blithely assumes that
leaving it to the hospital/health care system will take care of
everything she needs to learn (after the birth) and to do to get off to a
good start.

Just my $.02.

Jean
**********************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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