Danny,

I am sure you will get plenty of feedback from those currently in
practice to answer your questions.

As for the question about C. Section moms, I think teaching her the
Australian position, and role modeling for her significant others how to
assist her by handing her the baby while they learn, is one of the most
restful things that can be taught.

The weight of the baby's head tends to keep it more deeply on the breast,
and mom, with a large pillow to support the arm cradling the head, can
usually relax and drift off to sleep if desired, with no fear of the
baby's slipping off to a shallow latch.

I agree with you that your idea about a prenatal class is a valuable
thing to reach the goals you mentioned. I started what I believe to be
one of the first such classes in the nation 25 years ago for our local
childbirth education association. I  trained half a dozen others to be
additional instructors, and we always had plenty of parents enroll. We
gave classes in 3 counties. The original outline might need a little
updating by today's standards, but if you don't get enough to give you
ideas, I would be glad to fish it out and send it to you.

We even offered  (to the couple) a voluntary private nipple function
assessment after the class, to add the dimension of the mother's
kinesthetic sense. Dads often remembered things the moms forgot, and
being included helped them be more supportive, I believe. We limited the
class size to 12 couples max, and just added more classes if necessary,
in order to keep the group at a manageable size.

I continue to believe it is helpful for the mother to be taught hand
expression using her breast as the teaching model. This is far different
from using diagrams or a cloth breast model.

I believe it is helpful to encourage her for to "practice" prenatally,
expressing one drop or so several times a week during her shower, so as
to become familiar with how to handle the breast as a feeding tool. There
are also different, separate "management tricks" that may be taught to
women with, say, a very pendulous breast compared to a mom with an A cup.
It is a wonderful time for reassurance!

(Our society has done a good job of teaching women to handle the breast
in screening for pathology or to look like a sexy fashion plate in an
infinite variety of bras, or steamy film scenes. I think learning the
"feeding tool aspect" deserves "equal" time, at least prenatally, versus
having to learn it all while sleep-deprived, coping with a tender
incision somewhere or other, being deluged with visitors, and perhaps
handling a newborn for the first time. Little girls in other cultures get
much more chance to "absorb" it than most American girls.)

Many of our teachers were also connected with LLL, and therefore had easy
access to a variety of new nursing mothers. They would choose one with
"charisma" plus a pleasing experience, and have her come in near the end
of the class to show off her baby, share her experience, and to hopefully
nurse the baby, deliberately exposing the breast for all the moms to get
a plain view of a good latch. One of the best teaching aspects of the
class! They could identify so easily with her!

We team taught it, and at the point in class described above, one of the
instructors took the men on the opposite side of the room in their own
group, focused on concerns of fathers, and facilitated a discussion
between any experienced fathers and the new fathers in the group,  Killed
two birds with one stone to do it this way! (e.g. privacy of a sort for
the nursing mother, with women only to peer directly at her, plus men
felt freer to discuss feelings and questions with other men.)

I would feel privileged to answer any questions you might have after
reviewing all the answers you will probaby get.

K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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