<the baby is lined up
with mouth directly opposite the nipple - as opposed to nose opposite
nipple.  the hand on the same side as the breast shapes the breast, with
the thumb being quite close to the nipple and downwards pressure of the
thumb causing the nipple to then tilt 'up the baby's nose'.  All the rest
is the same... bottom gum as close to edge of areola as physiologically
possible.  There is more areola to be seen above top lip then below
bottom lip.>

<a common comment I hear from the midwives
is - the baby won't open wide to latch.  No when the nipple is just being
offered directly at the lips, few newborns see any reason to open very
wide.  But as soon as you tilt that nipple up their nose, the baby gapes
beautifully.>

Thank you, Denise, for this "eye-opening" explanation. So many new
mothers we see have trouble coordinating "Put the baby on to the breast,
not the nipple in the baby's mouth" and "Lead with the chin" and "Point
the nipple at the baby's nose".

I can't wait to try the placement of the thumb close to the nipple and
indent to tilt the nipple (and the lower areola) in such a way as to
stimulate a gape that places the deeper part of the areola right near the
tip of the baby's tongue where it belongs!

I'm also wondering whether we were inadvertently doing something close to
that when locally, we were advising the "teacup" hold of the areola and
"flapping" the nipple down on top of the baby's tongue.

Thanks a million. I foresee it will make it so much easier to explain,
not only in person, but over the phone.

Jean
************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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