<<This led me to refine my description of how the baby needs to be (when in cradle hold): "Lying on her/his side, with *two* hips, not one, against the mother's body." >> When dealing with this over the phone, I ask the mother if the baby's belly button is visible while nursing (thank you Faith Ploude for that tip! She's the best <g>) That's an easy visual clue for the mom. A simple yes or no tells me a lot about how the baby is positioned. Then I tell her that she should NOT be able to see his belly button while he's at the breast, because it should be up against her body. <<When it isn't, tools such as a pain scale (with clear descriptors of what 1 and 10 mean) serve to improve our ability to help the mother.>> That does make sense. I'm sure they're useful in some settings. Over the phone I can't see using one, because if a woman is in enough pain to want to call me, then already I know that something's gone wrong with the breastfeeding. It's either positioning or it's not, and if it's not, then the degree of pain won't tell me as much about what's going on as seeing her will or the location of the wound or timing of the pain (at latch on, towards the end of the feeding, throughout the feeding, and of course where any scabs or wounds are on the areola or nipple), all of which are easier to determine during a consult. But for that first phone call, to me she's simply a mom in so much pain that she's willing to seek out & speak to a total stranger about her breasts. That's enough of a scale for my purposes :-) Regina Roig Lane BS IBCLC for Miami-Dade County WIC *********************************************** 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