Barbara -- I thoroughly agree with your concern about the possibility of
creating a breast aversion through over-aggressive and mis-positioned RAMing.
 (RAM stands for Rapid Arm Movement for those Lactnetters who haven't met
this acronym yet.)  I suspect that the problems, such as you described, come
not from experienced LCs but from hospital staff who have only a shallow
understanding of this latch technique.

I too am meeting moms who are truly worried that I am going to start
thrusting their babies at the breast "like the lactation nurse in the
hospital", they will say.  However, I do know to take what I hear with a
pinch of salt (who knows how they describe their visit with me...).

Often the problem seems to stem from an insensitivity by the "RAMer" to the
cues from both mother and baby.  A firm and well-directed shove may be
exactly what's required but perhaps mom needs to understand the rationale
first.  And if the baby responds by feeding beautifully -- great.  But any
experienced LC knows to change approach if our "old favorite" positioning
technique doesn't work for the baby in front of us.

The most important fact I gleaned from a 2-day course taught by a specialist
in feeding disorders was that all feeding experiences should be positive from
day 1, whether on breast, bottle, finger -- whatever.  As LCs one of the most
valuable things we can do is teach those who work with babies (including
their parents of course) how to read babies' cues to know whether they are
enjoying their feeds or are being stressed.

And we also need to know how to support each other when we hear negative
feedback from parents by (1) redirecting the parent's annoyance from the
LC/nurse/physician (it's impossible to know what really happened so benefit
of the doubt usually a good approach) and (2) where possible letting the
original contact know the current status of mom and baby -- if we don't know
what happens after we see a baby how can we improve?  I hope you were able to
give some feedback to appropriate personnel in your local hospital.

Joanna Koch, IBCLC in Los Altos, CA