Jennifer,

Two things come to mind:  one is a teacup hold of the nipple/areola to form a
teat that Kay Hoover described at a recent talk she gave our consortium.
With first finger and thumb pinch areola into teat just a bit away from base
of nipple and kind of put this formed teat in babe's mouth.  I tried it with
twins who couln't latch onto mom's large, balloon breast and it worked and
mom was able to repeat on her own.

Also, I had a mom awhile ago who devised her own positioning/latch technique
for her baby with very poor sucking ability (seen by osteopath for CST with
good results eventually);  she sat on the floor indian-style, legs crossed in
front of her, put babe on pillows in this "hollow" and then was able to use
both her hands to form teat and get breast far into baby's mouth.  Also used
breast compression alot during feed this way which helped her little one get
milk more readily.  Baby is still BF at 6 mos now without all this gymnastics
but wouldn't be if mom didn't sooo want to BF.  This baby also had horrendous
clamping.

Cathy Genna has told me she uses clutch hold with large breasted women with
gd success-baby's belly to mom's side kind of clutch-the real football.  She
did help a mom I couldn't with this.

Hope this helps and good luck!  These are the moms who need 24/7 LC help-I'm
always tempted to take them home with me!  It's so hard and frustrating to
keep mom's going when it's so difficult for them but you're certainly giving
all you've got and that does help.

Barbara Latterner, BSN, RN, IBCLC
Brewster,NY

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