Dear Ellen, Altho this is repetitious because I've written before on
Lactnet  about BF APGARS, they are from when we were on another server and
I don't know if they are still available (6 Sep 1997 & 7 Sep 1997)   I do
not personally think LATCH is useful or practical.  It sounds real neat and
"nurse-y", but it really doesn't tell you how BF is going!

My main contention is that any system needs to be user friendly or it won't
be used!  Mom or staff!  I also think mom-based assessment is crucial so
when mom goes home in a day or two she has a way to know if she needs help
or follow-up.

The object of using these scores is so  that everyone (mom & staff) are "on
the same page."  Mom isn't saying baby is doing great when baby is really
flunking BF 101. Or nurse isn't observing feeding and saying BF well, when
that is not what is happening.  (I will never forget a mom who delivered
over the weekend.  Baby was BF well according to all reports, but mom's
nipples were rapidly getting sore.  She was encouraged to delay discharge
mon am until BF class was given.  After class when I worked with mom I
found a baby whose tongue was "glued" to the roof of his mouth.  He had
NEVER latched on once in 2 days with tongue down!  he wasn't really BFing
at all.  When we got him on right and mom felt how it should feel she was
amazed.  The expression on her face was priceless.  All of the nursery
notes said he was "BF well" at each feeding!

There are a number of scales/apgars out there.

Jan DeCoopman did one on BREASTS (Mom does the scoring.)
B- Baby awake
R- baby Rooting
E- baby takes in Enough of areola
A- Active suckling
S- Swallowing heard
T- Time- actively swallowing for 10-40 minutes
S- Satisfaction, baby Settles down

Each letter gets one point
5-6-7 mom and baby doing OK
3-4    mom ask for help if not better at next feeding
0-1-2 mom ask for help NOW

Jan suggests that this be printed on a 3x5 card and given to mom
prenatally, at first feeding, when she is getting help with latch-on and
positioning.  At discharge mom can be given card again.  My idea would be
to put community #s, warm line #s, BF class info, etc. on back.

Another is IBFAT by Mary Kay Matthews (IBFAT is Infant breastfeeding
assessment tool.)
Again mother is the assessor.  Developing an Instrument to assess infant
breast-feeding behaviour in the early neonatal period.  Midwifery
4:154-165, 1988.

A third is MBA  Mother/Baby Assessment by Chris Mulford. The Mother-Baby
Assessment (MBA): An "Apgar Score" for Breastfeeding.  J Hum Lact 8(2)
1992, 79-82.

SAIB is systematic assessmnet of the infant at the breast by Linda Shrago
and Debi Bocar.  "The Infant's Contribution to Breastfeeding."  JOGNN 19:3,
1990

Linda Kutner shared her hospital's scale at the ILCA conf in New Orleans in
1997.  Conference syllabus p. 32 (Page 10) of  Track 3: Clinical Management
of Post Discharge Difficulties: The Baby Who Refuses to Breastfeed.

I think this is an area that needs to  be explored further in the clinical
arena.
Sorry so long, I got carried away because I think this is an area that
needs great improvement in the average hospital.  Pat in SNJ

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html