In the many conferences I have had the privilege to attend, there have been  
many speakers who have addressed this topic ( Glover, Smiley, and  Wiessenger).
They all have made me re-look and rethink about positioning and  latches.  
What is the most important observation is that each baby and than  mother needs 
to find what works for them.  As babies get bigger and older,  adjustments are 
made.
I try the standard recommendations to mothers but if I observe them looking  
very tense or uncomfortable, than this is not a good option and have them try 
a  different approach.  Also, if a baby is unhappy with what should be a  
perfectly good position than they have their reasons and we have to believe  them, 
not push them, and give them a break.
Lately, I have been allowing the newborn (in the first 24 hours) to  just 
lick and mouth mom's nipples while she hand expresses her colostrum.   Allowing 
the babies to find their comfort and readiness to latch has brought  good 
outcomes for all.  
I can't remember who wrote the post on this topic that we need to be very  
flexible in our approach and understanding of our fellow LCs, but this statement 
 is so very true.
The only think I tell parents is not to push the baby's head into the  
breast.  They have to allow the baby some head extension when coming to the  breast.
Let's all learn from each other and know that the perfect position and  latch 
is based on the dyad and not our books.
Ann Perry, RN IBCLC
Boston, MA
 

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