In a message dated 4/21/2003 1:09:58 AM Eastern Standard Time, [log in to unmask] writes:

> My question was the opposite, to those who always dictated
> that moms always switch breasts, did they never run into
> problems with this?


I've got a feeling we're all saying essentially the same thing in different ways. Never felt it was up to me or anyone else to "dictate" that moms switch breasts. I think it's desirable due to implications of assignation all else being equal, but since most MOT I know tend to switch only on a 24 hour basis, I think that format may achieve the benefits (mainly to mom) of switching and "same breast" advantages for each baby. (If a mother was switching within or every other feeding, I'd still probably first suggest 24 hour switching for a few days before moving to assignation.) What I usually hear from a mother of twins is that a nurse, doctor or LC "dictated" assigning a breast (for no specific reason)--not the reverse. I cannot imagine giving a mother an intervention without some kind of rationale.

Following each baby's (x2 or more) cues re: OK with switching, demos a preference for a specific breast, or shows signs of not tolerating switching usually seems to work best. Or if a method seems the "thing to do" for a MOT, she should go for it. Bottom line--if it ain't broke, no point in fixing; but if it isn't working, try something different for several days--and if that doesn't work, try another something different (re: principles of outcome-oriented therapy).

Karen

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