Ione Sims asked for references on the value of not separating babies
and mothers.  I suggest she get hold of any Baby Friendly literature,
especially Step 7.  Hospitals all over the world are now implementing
the 10 Steps and there is overwhelming data to support the long term
value of these breastfeeding-friendly practices.

I recently spent 12 days doing a project for WHO in Thailand, where
70% of hospitals are now Baby Friendly.  It changed my thinking
about breastfeeding and made me realise just how many of the problems
we LCs face, and people on the Lactnet write about, are iatrogenic.
The Thai breastfeeding message is ubiquitous, elegantly simple and
the answer to everything:  "The three sucklings".
    1.  Early suckling (ie on the delivery table),
    2.  Frequent suckling (exclusive breastfeeding and NO mother
          baby separation)
    3. Correct suckling (good attention to positioning and
         attachment).

These are not token messages.  No separation means that the the
mother stays with the baby for everything.  Frequent suckling means
that the mother lies in bed on her side with the baby at the breast.
If you asked a mother how many times per day she feeds, she would
look at you strangely.  Better to ask whether the baby ever falls
into a deep sleep and drops off the breast for a while - they
occasionally do. We saw a lot of abandoned plastic cots.  I was told
that despite rooming in there had been a problem with jaundice.  They
got rid of the cots, put the babies in the beds, and the jaundice
stopped. That's frequent suckling folks, not what we play around
with.

When you need beds desperately and mothers can't be discharged until
breastfeeding is established and going well (2-3 days), you do
everything to make it work. The mothers feed all day and the nurses
walk around fine-tuning positioning and helping as required. Where
was the hypoglycaemia, engorgement, sore nipples, babies unable to
latch, etc.  Not to be seen.  I never heard a baby cry.  Yet these
are medicated deliveries, 100% episiotomy, up to 16% caesarian.

It seems that if the "Three sucklings" are really done well, the rest
can fall into place.  Now if every doctor and every nurse throughout
the world knew and practiced three things .......... we could be
bored, not burnt out.

Ros Escott
Tasmania, Australia
OK, who else thought of the three little (suckling) pigs?