Fiona:

It is certainly a matter of where one's comfort level lies when considering
when and when not to utilize a hands on approach.  I have always been a very
tactile and kinetic person and so touching someone (always with their
permission, and this includes speaking to a baby and watching for body
language that says "hands off") is a natural adjunct of who I am and what
works for me when dealing with others.  One method that works well in terms of
trying to assist mothers while simultaneously empowering them, is to place
your hands over theirs and help them guide the baby onto the breast.  When
trying to explain RAMing (rapid arm movement) a baby on to a mother who thinks
her baby will break if she really does that; assisting her to do a good RAM
will show her 1) the baby didn't break, 2) Yes, this does work better and in
the process she has had a chance to actually do it herself albeit with some
support from her HCP.  This will then give her a much better idea of what
exactly she needs to do.  Then she needs to be able to practice in front of
her helper/cheering section so she gains the confidence to continue correctly.
This same methodology works in any number of situations, like helping her to
encourage baby to open his mouth by applying some pressure to the lower jaw.
It is always fun to see how amazed parents are by how strong those little
peoples jaws are!  Getting comfortable with just handling a new baby can be a
significant issue - especially for first time parents.  Part of our job as
members of their support system is to use whatever means seem to work well to
help them get comfortable and work effectively in learning the arts of
breastfeeding and parenting.
Respectfully,
Gretchen Andrews, BA, IBCLC,LLLL
The Lactation Connection,  private practice
Redlands, CA