well for the staff you are targeting (nsy and mother/baby staff and peds)
this is the grand opportunity to teach latch, and the all important
component that goes with it...positioning. These techniques or skills I find
are known by few. Most of these staff will THINK they know what positioning
and latching are (not trying to sound snippy but I find this to be true
after 20 yrs experience). You could basically talk about norms for pain in
bf (IMO a little tenderness may be normal but not to the extent that the mom
dreads or hesitates to put baby on), a pain scale (I use 0-10 and if 4 or
higher I definitely want a consult done - this is subjective). Also you
could talk about nipple trauma (which goes hand in hand w/ pain) as being
abnormal. I think also that many hcps expect fairly severe engorgement as
being normal. Again a teachable moment that if baby is being bf effectviely
and frequently the engorgemetn will really just present as noticeable
fullness. You could also talk about bf and pain meds if that is an issue at
your facility. I am suggesting these topics, because at my facility, these
are major barriers. By the way, I have very very few mothers reporting
nipple pain or trauma. I take credit for good teaching and have been told
that the incidence of mothers being sore has drastically declined since my
coming on board there. The main complaint as far as discomfort, and whcih I
consider normal, is uterine cramping during bf.

Laurie Wheeler, IBCLC, MN, RN
New Orleans Louisiana, s.e. USA




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