Dear all:

I do not ever talk about cognitive deficit with mothers. I talk about right brain 
enhancement.  That  is, mothers intuitive right brain function increases after delivery.  
Since most of what infants need is careful observation and empathetic response --- the 
shift in brain function is appropriate and we should acknowledge and develop plans for 
mothers accordingly.  I've seen how mother's observational skills or just plain intuitive 
guesswork actually works quite well at times to develop creative adaptations.  I spend 
more and more time watching and trying to understand what mothers and babies are 
actually doing before I ever touch or advise.  From this, I have learned to very rarely use 
a U or C-hold on the breast.  Many mothers adopt a natural hand position for their 
breasts of fingers underneath out of the way and a finger or a thumb tip directly opposite 
the nose tilting the nipple to the roof of the baby's mouth, while some mothers use one or 
three fingers in the same fashion.  They often have a much more comfortable shoulder 
and elbow position when they use this approach than when they contort their hands into 
some sort of a "proper" breast hold.  So, I now suggest these breast holds more 
frequently when I see a mother contorted into some breast hold that created the shoulder 
hunch and "chicken wing" elbow.

This is also what I observed with sitting on mats at support group. Mothers would 
complain how much more painful it was to feed at home.  On the floor they would slump 
back a bit and lean against pillows without analyzing about the "proper" positions.  The 
subtle adjustments that they made on the floor when they didn't have the "proper" chair 
made a huge difference for some of them.

Yes, I always do provide written care plans for mothers so that they can read --- but the 
sensation of a good attachment is probably far more important --- as is the opportunity 
for mothers to have additional verbal reassurance and physical guidance for attachment 
when needed. But most of what happens in the Manhattan culture I deal with is too much 
trying to "analyze" the "proper" way to do things and then mothers feeling frustrated 
because they can't "analyze" they way they used to, instead of letting go and observing 
the relationship with their babies unfold and how their babies respond to their actions.

Best, Susan Burger

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