Hi Magda, yes, I was responding about bedside teaching tho haven't yet read
the Birth article.  I thought there was a request for other articles that
referenced efficacy of bedside teaching, so I was throwing the Avoa article
out in response to that.  It is very diff. to compare one study with
another -- esp. with such cultural variance, but I submit that any 30 min.
long teaching session with props, handouts, and info about anatomy is going
to be a lot for an immed. postpartum woman to tolerate.  I just acted as
doula for a young friend of mine, who had a lovely natural childbirth in
hospt.  She had a long second stage labor, and baby was born a bit stressed,
breathing was labored, and baby whisked off to nursery to lie under oxygen
hood for some hours.  This girl wasn't ready to have 30 min of bedside
teaching on day one or two;  she just couldn't take in.  She went home late
day two.

Mary Zeimer's work really suggests that sore nipples are fairly ubiquitous
and peak sometime around day 5.  So if the experimental group in the Birth
study had some fewer sore nipples that may point to some good being done.

I stand by my belief that a lot of early instruction for bfg. is not geared
toward where mothers are physiologically or psychologically.  I think just
brief sound bites of praise and encouragement from everybody from the doctor
down to the janitor would be useful, and each nurse should know asymmetric
latch and just help gently.  It would be wonderful if there could be some
community based support so that when moms suddenly come to (on the day they
get engorged and are hitting peak nipple sensitivity) they could get some
skilled help in their homes or a near-by clinic.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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