BWC says, << I have come to wonder about the wisdom of the "tummy to tummy" advice.>>

And, Barbara I've begun to wonder about the wisdom of "It's not supposed to hurt"!  I agree that this shouldn't be accepted blithely without checking for latch and milk transfer issues, but honestly, some moms are just going to have to put up with some tenderness until both they and their babies get
consistent about getting the baby on right the first time, every time.   And that can take a few days!  Sure, if I help them every single latch, perhaps they will not have as much soreness, but even I'm not that good, and I'm pretty good!  (I had a resident tell me last week after following me into
3 patient rooms and watching as I helped moms get babies latched, the last one screaming before we got there!- "How did you DO that?  I'm in awe of you!  That was my high point of the week.  It was a hectic week!)  We can give guidelines, but a good latch takes practice and sometimes you have to
settle for letting the baby slurp the nipple in because their fuse is too short to give you time to improve it.  And sometimes, babies are so aggressive at the breast that before you can get in the mix to show moms how far baby's head should be so that they can't slurp it in before you're ready,
they've already slurped it in.  And sometimes the only latch you can get is a mediocre one.  This is the reality of the first few days in the hospital.  There is time to improve, but you can't always get it perfect from the beginning.  Sometimes, I just cringe because I know the only thing I can
tell the mom of a barracuda nurser who's a comination of the above, is to hang in there and try this and try that, but that kid will get himself on and you may just have to grit your teeth for a few days until the nipples toughen up and/or the milk comes in!  Honestly!  Such a baby was just one of
my headaches last week.  He grabbed the nipple as soon as he was put anywhere close to it and suckled like a hungry lion cub.  Mom went home with a shield after two days of this just because of the soreness.  No nipple damage.  Just exquisite tenderness.  I know I've learned that there are no hard
and fast rules, just guidelines.  I think that's the beauty of our profession.  We can modify the process for the situation!

Marsha, in chilly Indiana where I lit up the fireplace last night for the first time this fall!

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Marsha Glass RN, BSN, IBCLC
Mothers have as powerful an influence over the welfare of future generations as all other earthly causes combined.John S. C. Abbot
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