My gracious, you all come up with some interesting questions!

But these questions aren't really the run-of-the-mill situations IBCLCs 
encounter day in and day out.  I work in a hospital with 8000 births/year.  
Yes, I see a mom who had an augmentation surgery once a week, smoking 
only gets admitted to (!) every few weeks, Reynauds comes up only a few 
times a year. Extended breastfeeding doesn't come up much in a professional 
setting, because those moms have learned that it's LLL that really knows 
breastfeeding.  The IBCLCs who come from an RN-only background tend to be 
much more focused on the early days of bfdg rather than the toddler and 
beyond stages.  I've seen a cleft palate once in four years.

So my question back to you is:  Is anyone at Ivy Tech teaching the normal 
course of breastfeeding## and the oh, so, important subtleties of what makes 
a good latch for comfortable milk transfer?  Without good milk transfer, supply 
will suffer, growth will falter, and the more difficult questions you're asking will 
become non-issues.

If you haven't read it yet, my current very favorite for a tremendous 
foundation to the entire "world" of breastfeeding is Kathleen Kendall-Tackett & 
Nancy Mohrbacher's *Breastfeeding Made Simple.*  Please start with that.

Next read *The Womanly Art of Breastfeeding.* Only after those two, go on 
to whatever other aspects of breastfeeding may spark your curiosity.

Please be sure you've seen Kittie Frantz's "First Attachment" video with the 
segments on Self-Attachment. Or watch babies placed skin-to-skin self-
attach during your clinicals. Have you watched the video at 
www.breastcrawl.org?  (Christina Smilie, do you have a video separate from 
your wonderful lectures on Self-Attachment?)

I worry that Ivy Tech students are losing the big picture with so much focus 
on specific, scientific details about unusual situations.  The moms and babies 
you'll be serving need you to know the very important fundamentals so you 
can instill confidence in the mother that, yes, she can breastfeed her baby!

##Linda, the "normal course of breastfeeding" (as mentioned above) includes 
natural weaning at whatever age the baby/child does it. To me, every mom is 
entitled to breastfeed through her child getting the two-year molars because 
that child is going to be waking up again several times a night.  What's the 
easiest way to put a child in pain back to sleep? 

Also if you check the AAP's 1997 statement and compare it to the current 
statement, I think you'll see they're trying to ease American women into the 
idea of getting closer to the WHO recommendation of "shoot for two."

Please hang in there with your fascination for breastfeeding!  From my field, 
we're seeing more and more that breastfeeding in the early days truly 
programs a baby/child/person's metabolism for life~~~not to mention all the 
other benefits!

Wishing you the best of luck with all your studies---and an occasional nap, 
too.

(No financial interest in any of the references mentioned, just great passion 
and respect for what the authors have brought to us.)
Debbi Heffern, RD, IBCLC, LLLL
St. Louis MO

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