Dear Fiona
I will send your message on to Heather Harris, who is not receiving Lactnet at the moment.  Heather's implementation of a "Hands off technique" at the Women's Hospital in Melbourne has been accompanied by a reduced rate of nipple trauma.  
Joy Johnston
www.webrider.net.au/~aitex/joy.htm



-----Original Message-----
From:   Fiona Coombes [SMTP:[log in to unmask]]
Sent:   Friday, March 20, 1998 10:29 AM
Subject:        hands on/hands off

Hi everyone
I'm going to ask 1600+ clever people what they do in their day to day
work. I am usually hands-off when it comes to helping mothers with
attachment and positioning. We discuss, describe, then mother tries
things herself, with some coaching from the sidelines.
Often mother and myself (and baby) get very frustrated at the try and
try again method.
Do any of you use a more hands-on approach to guide mothers in what
to do - eg your hands over their hands. I often wonder if helping
them 'do it right' once or twice gives them the sensory input and the
confidence to try it themselves, and circumvents some of the
frustration.
Some women seem to have made up their minds that things won't work by
the time they get to my door. Baby is 3-4 weeks old, mother with sore
nipples, and she tells me that baby just WONT open to a wide gape
whatever she does. I give all sorts of suggestions, demonstrate with
hands etc, but mothers seem to make very half-hearted efforts to try.
It's almost as if they are trying to prove that it just won't work
(or maybe I'm paranoid!!!).  In those cases, I'm really tempted to be
much more hands-on, get baby latched on well, and then work through
what we just did together.
Anyone else have that approach? What works for you??

Fiona


Fiona Coombes MBBS IBCLC               [log in to unmask]
Lactation Consultant, Family Physician
Perth Western Australia