Re: recent exchange here on Lactnet about "What 3 things would an LC choose to include if given the opportunity to make up a 3-point packet to give to all OB-Gyns in her facility: <>> Evidence doesn't support prenatal nipple exams as being all that helpful.<< <I agree! And even if they were, I'm not sure that a "nipple diagnosis" by an OB would translate well into practice as they typically don't get very involved with the practical aspects of breastfeeding.> I think there is room for disagreement here. As to "evidence", I think the conclusions drawn are very wide and faulty for making a blanket decision to virtually ignore taking any clues from nipples observed prenatally. I think there is value in the opportunity to reassure 95% of mothers and at least for the remaining 5%, prenatal referral. Specialized teaching and advanced planning for management of the initiation of lactation can be of tremendous help in certain situations with potential for problems. A mother may get into unnecessary problems if she blithely assumes that leaving it to the hospital/health care system will take care of everything she needs to learn (after the birth) and to do to get off to a good start. Just my $.02. Jean ********************** K. Jean Cotterman RNC, IBCLC Dayton, Ohio USA *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html