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Subject:
From:
"Christine Erland RN.IBCLC" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Mon, 15 May 2006 23:30:06 -0400
Content-Type:
text/plain
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To Kermaline Cotterman: Hopefully I am not posting this twice, 
my computer said 1st didn't go through. I try to do as much 
hands off teaching as I  think possible. I explain,show pictures 
and use a doll and breast model. If the mom is still having 
difficulty I put my hand over hers to assist her in helping the 
baby latch. I try to stay long enough to have her help the baby 
unassisted. Then I sit on my hands figuratively, seriously I 
clasp my hands behind my back,reminding myself that I won't 
be there to help her later. I rarely get to see  a patient more 
than once but do follow up by phone. Frequently when I see the 
mom she is almost ready to give up breastfeeding, she is giving 
it one last try with a Lactation Consultant.
 I rarely see extreme engorgement anymore thankfully. When I 
do I have her lie down, stroke back  and toward armpits with 
arms up, then pressure around areola to make a ledge for 
infant to latch. Thank you for this technique Kermaline, which I 
have poorly described. I play it by ear. I ask the mom if she 
wants to try it, if she wants help I show her. They are 
frequently so stressed at this time, I think hands on is 
therapeutic in this situation and they  start to relax.If 
engorgement is extreme help is usually hand on. Chris Erland

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