To Kathy Warmbier and Diane Wiessinger Thank heaven for your posts. I was really beginning to wonder if I was hopelessly out of line and unaware of my personal boundary issues. Kathy, you have taken it one step further than I ever dared to take it, as I only had consenting roommates or maybe 3 mothers together when everyone was being helped, assessed and nursing in plain sight of one another all at the same time. Perhaps 20-25 years ago wasn't the cultural season for that yet, before films of premi moms in other cultures expressing milk together as a group! My main experience with breastfeeding mothers began on the night shift as the only postpartum nurse, or at other times the only nursery nurse, for as many as 25-30 patients "back in the good old days" as the "baby boom" was winding down, but still with the same old routines, 3-5 day stays and universal engorgement. After 9 years of having worked L&D, and later on postpartum, before recovery rooms came to be, caring for mothers who all had to stay in bed for 8-12 hours or more after delivery, of course, touching a mother's breast didn't seem the least bit invasive to me! As I became more experienced, (and I KNOW that I had many overzealous moments) I found so many mothers so appreciative, often saying "Why didn't someone else show me that!" A few years later, I switched shifts and also began teaching the hospital's CBE and baby care classes. I tried to teach a few skills with charts. (no video machines then, and no breastfeeding films to run on the 16 mm. movie projector. I suppose I gave a lot of pie in the sky from the front of the room.) When I met those same mothers a month or two later on the postpartum floor, I often told myself "She didn't understand a thing I said!" I was very angry with obsetricians for not even LOOKING at nipples during the 3rd trimester and for not teaching these things to mothers when they were the ones with access to them prenatally! I grew frustrated at trying to make changes within the system and so made an "end run" around the doctors by going to the consumer. Through an independent CE organization, I began to offer separate prenatal breastfeeding classes which included voluntary private nipple assessments. I saw mothers on the postpartum floor who seem to have benefitted. (At least, I guess I wanted to believe they did. No formal research, just a personal impression.) The classes were so well received that 8-10 other instructors were trained and the classes, including private assessments at the end of the class, began to be offered in 5 locations in a 2 county area. I was not the only one strongly convinced of the value of 3 dimensional learning by combining the simultaneous use of touch, sight and hearing. We were highly flattered when Jan Riordan, and later, Sarah Coulter Danner heard what we were doing, and each included a visit to us as part of their early research and writing. I don't know how much they agreed with in the end, but each seemed sympathetic to our efforts and supportive of our goals. My philosophy has been that it is through her KINESTHETIC sense that a mom will EXPERIENCE any pain and/or swelling that develops through a poor latch. Therefore, a little kinesthetic TEACHING she can choose whether to PRACTICE now and then in the shower prepares her with some skills that can "head (the pain) off at the pass" (just a phrase out of old U.S. Western movies that expresses the idea of being prepared with another plan if things don't go as hoped for.) I have never subscribed to the philosophy that a poor latch is ALWAYS or MAINLY the baby's problem or fault. I have seen too many cases when a mother's subareolar tissue resistance is too much for the most cooperative baby's best efforts. I always emphasized to moms that we had no advance understanding of what her labor or her "feeding partner" would be like, and that we were training mom to be the baby's teacher in case the two of them disagreed about how they would cooperate in the SHARING of her nipple! After all, it's part of HER body, and I believe SHE deserves some control over how it goes into the baby's mouth, how long it stays in at any one time, and how it comes out! I guess I feel a mom has a right to choose not to be a sacrificial victim or a martyr, naively expecting the miracle of natural results when so many unnatural interventions and/or complications can get in the way in even the best U.S. hospital system! Most expectant mothers have heard horror stories "by the grapevine" that breastfeeding is VERY PAINFUL and I sincerely believe this is one reason why so many refuse to even consider trying. I am certain that my philosophy developed in large part because of my own personal memories of how disappointing and devastating to my ego it was to stop at 5 days with my first three babies because of the excruciating pain of cracked bleeding nipples. It just hadn't been fair. When I finally "made it" past that stage (with the help of LLL) with my fourth and discovered the rewards, I felt I had been gypped out of something very special with the first 3. I was determined to try to do better by the moms I could help by anticipatory guidance OR postpartum or nursery care, wherever it was that our paths crossed. I later moved this anticipatory guidance from the CBE classroom to the public health prenatal exam room as just one part of my prenatal teaching. I knew I would not get to see these moms after delivery, but I found them receptive when I told that them I had helped mothers in the hospital for many years, and could show them some skills that would help them get off to a comfortable start. Sorry for the length, but I hope it helps the overall cause of providing better breastfeeding experiences. K. Jean Cotterman RNC, IBCLC Dayton Ohio where it was nearly 70 degrees today! ___________________________________________________________________ You don't need to buy Internet access to use free Internet e-mail. Get completely free e-mail from Juno at http://www.juno.com/getjuno.html or call Juno at (800) 654-JUNO [654-5866]