We have asked a lot of medical people (nurses and midwives esp.) to support
mothers in the initiation of breastfeeding (because they are the ones there
with the mothers in hospitals and birthing centers) without ever providing
them with any education to do so.  That is expecting people to know
something without training them.  Whether we want to quibble about
"medicalizing" breastfeeding or not, we might want to consider trying to
actually teach the priniciples of good latch to these people.  This might be
a bit difficult, because as far as I can see, there is still a lot of debate
about what a good latch looks like.  And because a lot of people seem to
think this is easy and they know how to do it.  I still think that
understanding latch and positioning is THE basic skill of lactation support,
and that it requires a fairly sophisticated conceptualization.  This is not
to say a fancy vocabulary is required to teach it nor a degree to learn it.
But it is important to understand the mechanics.  There are aspects of it
that I know I am still struggling to understand.

Diane Weissinger and I have had a lot of discussion about the competing
vocabularies our profession uses to teach latch.
And Jack is right.  People have to be able to identify nutritive sucking.

If we could get two hours inserted into nursing/medical  school curricula: 1
hr on mechanics of good latch, and 1 hr on the diff. between nutritive and
non-nutritive sucking (with some advice about abandoning time tables so long
as intake/output are adequate) we could have fewer of the normal dyads
fouled up.  There are still going to be babies and moms in the 'not normal'
categories who will need special intervention.  These will require more
skilled support.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.lactnews.com

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