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Lactation Information and Discussion <[log in to unmask]>
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Sun, 26 Mar 2000 15:02:22 EST
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I think it takes a lot of working with breastfeeding moms and babies and a
lot of "having the feel" for how breastfeeding works to understand how to
fine-tune latch.  I think a lot of nurses and doctors are really trying but
are not there yet.  I have in-serviced nurses at my hospital on latch, but it
takes more than a once in a couple of years inservice for it to really sink
in.  Even though they see moms and babies every day.  I do think it is more
subtle and complex than, say, learning how to assess funduses or cervical
dilitation.  As Barbara said, there are times I'm still baffled by it.
Having said that, there are also different levels of commitment to learning
it.  I tear out my hair when a nurse who I know has gone to my inservice (or
slept through it, I guess) says in report "I know the baby is nursing well
because her nipples are already getting sore" or charts "nursed well" in
every space and then I work with the mom and find out that the baby has never
really latched on.  Reminds me of Kittie Franz's definition of WNL (usual
medical abbreviation for "within normal levels") as "we never looked".

A brief post-script on the test-weighing discussion:  I think it's obvious
that the whole point is that it be used by someone who "has a feel for
breastfeeding" and approaches it as a normal physiological process that
usually works without measuring and quantifying and uses it rarely and
appropriately.  And that it not be called "test weighing"  to the parents.
When I need the more technological or quantifying approaches with moms and
babies, I spend a lot of time explaining and reiterating that this is
temporary, that this is not what they will be doing when things are going
well, and talking about expectations for normal, relaxed breastfeeding.  I
also refer them a lot to LLL meetings to learn what is normal.    Miriam

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