I just thumbed thru JHL and saw Cotterman's contribution to consultant's
corner (I use this demonstration with my hands too!) that mentions
palpating the nipple-areolar complexes to identify actual placement,
size, and character of milk sinuses.  I believe Linda Smith has info on
this subject as well on her website, which I have read. However, I still
do not feel expert at doing this, even though I am very successful
expressing colostrum from mothers and teaching them.
However I just use the general rule of starting about 1 inch behind the
nipple (usaully the edge of areola depending on areola size). Any and
all advice, tips, instruction from you experts would be welcome. Here is
something I feel is very important in LC education - much more on breast
assessment, normal and pathology. I mentored with 2 IBCLCs as part of my
graduate nursing program but this was not taught to me.
Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, USA
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