I have found that it is sometimes hard for me to explain what I want the
mother to do when I teach her to hand express.  A mother taught me to
say "pull" instead of "push" your hand in.  (This is what it is from the
mother's perspective.)  A staff member told me to say toward your "body"
instead of your "chest wall."  I actually now use both.  It seems to
help.  Chele Marmet taught me to say "Roll your fingers as though you
were making a finger print and a thumb print at the same time."  This
explanation usually results in all kinds of motions I don't want.  If I
am at the bedside I can demonstrate, but what do I say when I'm talking
to the mom on the phone who is engorged and can't get her baby to
latch?   What do you say?

BTW, when I talked recently about standing beside the mother, that was
with the hospital bed in the "up" position with my back straight and at
mother's eye level.

Bonnie Jones, RN, ICCE, IBCLC
from the sunny S.W. USA