Here's my thoughts on the discussion re bf classes and mentioning nipple
shapes, etc.  First, I think most instructors know their clientele/population
and should emphasize certain topics according to what they know may be a
concern for that group.  The first thing I say in class is that many of the
participants are taking 5 or 6 wks of childbirth classes, and yet L&D only
lasts hours.  BF should last months or yrs and we only have a 2 hr class.  So
I encourage everyone to read more about it and I recommend some books (which
I have to pass around in class).  I say up front that I can only cover the
most important points and I focus on positioning, latch, how breasts make
milk and how to increase (supply and demand), and how to tell if baby gets
enough.  I make sure to talk about diet and that you don't have to eat
perfectly to bf.  In my area we have less than supportive peds and I make
sure to tell them all of the reasons they may be told to wean.  I urge them
to interview a ped before the birth, and not just ask "do you support bf" but
to ask "if my baby is jaundiced, what will be done, if my baby goes to NICU,
if I get mastitis, or need to take a medication for such and such"  This way
they will really find a bf friendly doc.   I DO mention that some moms are
concerned about or have heard about flat and inverted nipples, but that most
babies do well with whatever nipple mom has, esp. if fdgs start early, often,
room in, avoid artificials, etc.  I say if anyone has concerns about nipples,
please call me or my coworker and we will discuss how to evaluate and
interventions if needed.  I really don't push interventions, I am not
convinced shells even work.  Lots of moms are concerned about returning to
work, and many do at 4 - 6 wks!  I say that I cannot talk extensively about
return to work, because all moms have different schedules, jobs, etc.  I tell
them they will generally have to express at whatever schedule baby is
currently on, and to call me few wks before return to talk about their
particular situaiton.  Since our classes are small and bf rates low, this
works. Sorry so long.
Laurie Wheeler, Rnc, Mn, Ibclc
Violet LA