Laurie,
Breastfeeding is another of many learned skills for humans.  In many
cultures, girls grow up watching mothers breastfeeding as a matter of
course.  How to offer the breast and hold the baby is transmitted the
same way as how to cook in these cultures.
        The reason that positioning is so important is that newborn humans have
no intrinsic stability of their own.  They gain all their stability from
external support.  Stability is essential for optimum muscle
functioning.  Try lifting your arm over your head and cutting an
intricate design with a scissors.  Much more difficult than if you held
your arm at your side and just flexed your elbow....  Anyway, some
infants have good enough oral motor skills that they can get enough milk
even if they are not positioned or latched well, others do not.
Latching on is a stability issue as well, the infant tongue is only
stable if the mouth is full of breast.  Righard showed that infants who
were exposed to narcotic analgesics during labor and especially infants
who were seperated from their moms after birth did not self attach to
the breast, and were less likely to suck properly.  I think these common
insults in industrialized nations make the issue of positioning more
vital for babies, but it is important anywhere.
--
Catherine Watson Genna, IBCLC  NYC  mailto:[log in to unmask]