This got lost in the lactnet make-over, so I am resending.
>Bodies can be "positioned" exquisitely with mouths still positioned quite
ineffectively on breasts. I often think of this when moms say to me "They
(hospital staff, MD's office staff, etc.) checked my "positioning" and
said it was ok.", when it's obvious to me from observing the mother and
baby that no one really had a clue.<
That is why, as Heather alluded to, here in the UK we speak of 'positioning
and attachment'. When I teach health professionals or Supporters, I always
say that the point about positioning is not an end in itself, but that the
positioning tips I give are often able to facilitate good attachment.
I am usually discouraged that published papers and books continue to show
fairly poor pictures of positioning and even more awful pictures of
attachment (if they show it). It is no wonder this continues to be a source
of difficulty for women. That is why I wondered what the content of the
intervention in the Australian RCT was. For example, I have an article from
2001 Journal of Midwifery and Women's Health (Jan Weingrad Smith and Mary
Rose Tully) 46(6) 423-38, which has pictures and talks about needing a
pillow in the 'across the lap' position. Now, I usually use that position
to start with, and I *always* get rid of the pillows to begin with,
reintroducing them only if required. So, if someone were teaching that as
the intervention, with the pillow, I would suspect they had missed some of
what I consider crucial (how the mother's body supports the weight of the
baby and how the baby is tucked in to the mother) and I would be less
surprised at an outcome which tended to undermine breastfeeding. (And in
the other positions in these pics, the baby's ehad is in the crook of the
mother's arm. Don't get me started!)
Magda Sachs
Breastfeeding Supporter, BfN, UK
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