Hello to all.  Can I vent?  I saw a sweet couple several days ago whom I had
in a prenatal class I teach for a local OB.  They came to see me completely
unnerved over the exper. they had in the hospt. with a "lactation nurse"
(they don't know if it was an IBCLC or not) who "pushed and shoved the baby
into my breast."  The mother was afraid to tell the nurse to stop, but baby
cried until she gagged.  Mother had decided to bottle feed pumped milk
because the whole exper. is so negative with this now-aversive baby.  When
she came to me for a pump, I told her I would support any decision she made,
but practically begged her to let me show her how to allow baby to
self-attach in side-lying.  Luckily we had a nice exper. and all three of
the adults present (parents and I)got misty while baby happily suckled.

Can I briefly explain to those who still follow the  RAM-the-baby-on
philosophy why this won't work?  Put your hand on the back of your head and
push.  What happens to your neck  as your chin digs into your chest?  For
one thing your airways are collapsed.  Can you imagine trying to swallow in
this position?  For another, you can't open wide.  For another, as the chin
retreats away from the breast, it is unable to close on the round part of
the breast.  At best it may grab hold of the nipple and pinch it as jaw
closure occurs -- producing the dreaded NUK shape which opens positional
cracks. Nursing in this position will always hurt and will never adequately
drain the breast.  Pain and poor intake spell disaster to lactation.

 NEVER BRING BABY TO BREAST BY PUSHING ON THE HEAD BECAUSE IT DOESN'T WORK!
Back the baby off from the nipple so it strokes the upper lip or nose.
Allow baby to HUNT for the nipple with head slightly tipped back.  When baby
gapes, bring baby on by putting pressure on shoulders, torso, and remember
to bring hips in close.  This aligns baby with chin digging into the breast,
nose slightly backed away.

All the mothers who have had their babies shoved at them feel that they are
forcing the child.  This is a bad feeling, and they are right that this is
not correct.  The idea is to allow baby control and to gently bring baby on.

We are lactation consultants.  Our responsibility is to know what the
accepted techniques of our profession are and the rationale behind them.
Study infant physiology and read the literature which discusses how to latch
babies.  Chole Fisher. Mavis Gunther. Felicity Savage-King's wonderful book
has GREAT diagrams.  There is no excuse for people to still be saying to
mothers in pain "Gee, it LOOKS ok.  I can't figure out why it still hurts."
And there is CERTAINLY no excuse for lactation consultants using discredited
techniques to be creating aversive babies.

Sorry for the vehemence, but I'm embarrassed by this sort of thing.  It
makes us all look bad.

Barbara

Barbara Wilson-Clay, BS, IBCLC
Private Practice, Austin, Texas
Owner, Lactnews On-Line Conference Page
http://moontower.com/bwc/lactnews.html