I have had much success using the asymetrical latch and the techniques
in Follow Me Mum. The nipple is put right under baby's nose or on his
top lip. I see that this gets the baby to open very wide and come in at
a nice angle. I also have had success using the nipple sandwich
technique of compressing the areola just above where the lips will go to
make sort of a shelf so more goes into the mouth.

Also, what I would like hospital LCs to teach is active sucking not
sleeping at the breast, proper latch on (nipple to nose technique for
most situations with wide lips), what milk transfer looks like, diaper
counts, how the breast makes milk, weight loss and weight gain. If moms
know this, they tend to avoid bottles and have more confidence. Plus if
problems occur, they catch them early. I used to spend about 10 minutes
in each mother's room explaining this, longer if there were problems. I
would show mom what active sucking looks like and satiation -- this is
very important. I devised a checklist to remind me of what to teach.
Sometimes you see so many patients you forget everything!

Kathy Eng, BSW, IBCLC

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