I have worked out in the postpartum world, and often wondered at mothers
who said "The nurses said I had flat nipples." We have that one figured out.

Now if we could just get a handle on the reason we most often see nipple
shields in our facility: a mom who is having a hard time reading her baby.

I love Kathy Kendall-Tackett's blogpost on the Science & Sensibility page;
:How Too Much Information Can Cause Problems for Breastfeeding Mothers" at
http://www.scienceandsensibility.org/?p=559

In the midst of our discussion last week I gave a mom a nipple shield - at
one o'clock in the afternoon, no less! - because we had just plain run out
of options. The mom even had great nipples, and it was her second baby.
There is of course a tremendous back-story (and I am privileged to know a
LOT sometimes because I teach Lamaze classes too....).

Our breastfeeding initiation rate here is 90%, and many - in fact MOST - of
the moms here have told us they plan to breastfeed to a year. It's very
cultural. Our duration rates do not look like this, however.

This mom just could not read the baby. And I would say, many, many of the
times we end up using a nipple shield - well, a tongue that we currently
won't see clipped in-house is #1. And a mom who needs more time to fall in
love and learn her baby is #2. And we are doing LDRP care, our nurses rock
when it comes to breastfeeding support - and sometimes we still use
them....and educate around them, and still moms don't use them right and
etc etc - but we kept them going for one more feed, and maybe it will all
kick in sooner rather than later and go better.

Because the bottom line is, the challenge is always to live life in the
real world. And we are glad to have plenty of people to send moms to after
discharge that can continue the help.

Otherwise we'd have to have a lot more wet nursing than we have now.

Dawn Kersula - sharing her own truths from Brattleboro, Vermont where we
are wishing for more snow.

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