Sarah:

 I'd like to comment on your question about forming the nipple into a nipple
sandwich.  My experience has been that there are a lot of techniques to try,
and some work for some babies, some don't, and you can never tell ahead of
time which techniques will work.  It's mostly trial and error.

Sandwiches seem to work well with some babies who can't get a full mouthful.
Sometime stretching the nipple by holding a tiny bit of skin on the side of
the areola will help a baby who needs to feel the hardness of the fingers to
get him going.  (He'll nibble his way on) This will work on mothers with
highly elastic skin and heavy breasts. Some babies need to have the nipple
aimed up so that they can get enough of the breast tissue underneath the
nipple in their mouths.

What I am trying to say is that they (LLL and Ruth Lawrence) are both right
and sometimes both may be wrong.  It depends on the baby, the breast, and the
situation.  Both methods can result in less that optimal attachment, but
frequently that attachment can be modified by position changes once the baby
is on. (Pulling the baby's bottom or shoulders in closer to mom, lifting the
breast etc.) Also, sometimes all these methods are too aggressive and you
need to back off for a while and wait for the baby take the lead!

Be creative. You might invent a new technique!

Karen Koss in Brighton, MI
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