I like to call these things BF apgars :-) Personally I find LATCH unwieldy
to use and pp nurses really complain about using it. There are several
others, they all have their pros and cons, tho. Counseling the Nursing
Mother (3rd ed.) covers LATCH; B-R-E-A-S-T Feed observation (UNICEF);
Barger and Kutner's method; Mother-Baby Assessment (MBA) by Mulford, IBFAT
Infant BF assessment tool by Matthews.
Biancuzzo in BF the Newborn: Clinical Strategies for Nurses has a chart
that compares IBFAT, MBA, LATCH and SAIB (by Barger and Shrago). She goes
on to say that "to be clinically useful, however, these tools must be
clinically reliable (consistently measuring the concept or behavior they
intend to) and valid (the extent to which the tool measureswhat it says it
measures)." So far in their development, [IBFAT, MBA, LATCH] were
described in one study (1997) to be neither valid or reliable and SAIB
hasn't been studied.
Personally I like Jan De Coopman's because mom does the scoring! However,
I don't know anyone who has used it systematically since Jan left Sinai
about 6 years ago.
B - Baby awake
R - baby Rooting
E - baby takes Enough of the areola
A - Active suckling
S - Swallowing heard
T - Time -actively nursing 10-40 minutes
S - Satisfaction - baby settles down.
Each letter gets one point
5-7 mom and baby doing OK
3-4 mom to ask for help if not better at next feeding
0-2 mom to ask for help NOW
Jan suggests that this be printed on a 3x5 card and given to mom prenatally
and again at first feed, when she is getting help with initial latch-on,
positioning. Nurses can go over the points when asking mom how BF is going
(we all know that actually getting into a room and observing a BFing is
next to impossible in this day and age. At discharge mom would be given
the card again, my idea - community resources, warm line #s, BF class info,
etc printed on the back of the card.
I particularily like that using this tool is a collaboration between mom
and staff. Mom reports and staff documents. After all in a day or two
mom will be evaluating the feeds all on her own at home.
I've said it before and I'll repeat myself - any tool must be user
friendly (mom or staff) or it won't be used, period! And I know we are all
tired of filling out papers for paper's sake! Sincerely, Pat in SNJ
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