I want to second Rachel's views on engaging the mother in conversation 
while she is expressing milk.  This works so well!  I do this for a few 
minutes with moms, then often tell the husband or other helper to do the 
same thing.  Mom's gaze is no longer down at her breast, and neck 
tension is relieved. Moms also spend too much time staring at the latch 
to "check it".  Of course, after the baby's latched you can't change the 
position anymore, but I have come to believe that you can inhibit your 
letdown by inducing neck tension.
And Nikki's description of skin to skin and the ensuing relaxation is 
beautiful.  I think skin to skin contact is magic.

Kate Sharp
Private practice
New York City

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