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By Andrea Eastman, MA, CCE, IBCLC
From: LEAVEN, Vol. 36 No. 4, August-September 2000, pp. 63-68
There are many pieces to this dance of positioning and latch-on that occurs between mothers and babies.
Leaders around the world understand how important it is for mother and baby to be positioned well to avoid sore nipples and breastfeeding problems. This topic is covered in many books and videos, some in more depth than others. In some books, the text says one thing but the photos say another and do not illustrate optimal positions or latch- on. Finding consistent, accurate information about positioning and latch- on techniques can sometimes be a challenge. Each person and each institution may teach these techniques in different ways. Problems often arise when an institution or individual gives more emphasis on teaching one particular position to every mother and baby.
In 1989 in the Journal of Human Lactation, Mary Renfrew wrote, "To insist that the baby is positioned precisely in the way that the caregiver has been taught will be counterproductive unless there is careful consideration of the effectiveness of that positioning, and the individuality of both mother and baby. This individual patterning can be seen as a dance between mother and baby."
Renfrew continues, "This dance simply needs reinforcing and encouraging rather than controlling and limiting. The concept of 'managing' breastfeeding as often referred to in textbooks implies control and is unhelpful. The mother and baby manage their own feeding experience with sensitive input and assistance when required. In gaining a greater awareness of positioning techniques, we must avoid overemphasizing the technicalities at the expense of the individuality of each mother and baby."
We all prefer telling mothers about the breastfeeding positions that worked well for us because of our familiarity with them. We tend to avoid mentioning the positions that we ourselves did not favor. Some mothers and babies breastfeed well in every position and other mothers and babies may rely on one or two positions as they are learning to breastfeed. What works for one mother may not work for another. What works best at one breastfeeding session may not work well at the next.
Mothers need to have the opportunity to learn all possible breastfeeding positions, all possible ways to hold their breasts, and all latch-on techniques. This allows them to choose what works best for themselves and their babies. Let the mother know it should not hurt to breastfeed and trust her to find a position that does not cause pain. Trust the baby to know when he is correctly positioned. When baby is in the position that works best for him, he will be rewarded by his mother's milk flowing into his mouth. Trust the mother to know her baby. Give mother and baby time to learn from each other. Empower the mother with knowledge and trust her to choose wisely. This is after all the heart of LLLI philosophy - that each mother knows her baby best.
It is important to watch how mother and baby interact with each other and how baby behaves at the breast. Observe the cues that mother and baby give each other so that they can be reinforced if they are working well. Baby needs to be deeply attached with a mouthful of breast so that he can transfer milk effectively. Mother needs to be pain-free and her nipple should not took compressed or misshapen when it comes out of baby's mouth. Mother needs to be attentive to baby's signals so that she is able to offer her breast on cue. If all of these things are happening then it doesn't matter whether mother's technique is picture perfect. Mother and baby have found a position that works for them and we should not interfere. In other words, "If it isn't broken, don't try to fix it!"
The Breastfeeding Answer Book describes the cradle position: "To get comfortable, suggest the mother use pillows behind her back and shoulders, under the elbow of the arm she will be using to hold the baby, and in her lap to support baby's weight. The mother holds the baby securely, with his head resting on her forearm or in the crook of her arm, whichever is more comfortable. His back is supported by her forearm, and her hand cups the baby's buttocks or thigh. The baby should be positioned on his side with his knees pulled in close to his mother. He should not have to turn his head to take the breast. If he were naked, his umbilicus would not be visible. His ear, shoulder, and hip should be in a straight line. The baby's bottom arm can be either under the mother's breast or tucked around her waist, depending on which is easier and more comfortable." Kay Hoover, LLL Leader and IBCLC from Morton, Pennsylvania, USA, suggests that another possible position for baby's arm is to place it across his chest.
Many experts encourage mothers to place baby's head on her forearm rather than in the crook of her elbow. For a large-breasted woman, the crook of her elbow may be too close to her body for the baby to reach the breast. For some women, putting the baby's head in the crook of the elbow places baby's head too far to the outside of the breast. This could mean that in order to latch on baby must drop his chin to his chest. Putting his chin to his chest means that baby's lower jaw and tongue, which do most of the work of breastfeeding, are too far away from mother's breast. Baby cannot get a good mouthful of breast and may end up shallowly attached or hanging onto the nipple. It can be hard to swallow with the chin on the chest.
The cradle position is one of the most common nursing positions. It is the one that is featured most frequently in photographs in books and is the position that many experienced nursing mothers favor. Unfortunately, the cradle position can be a challenge for new, inexperienced mothers to learn. It can be difficult to control baby's head when using this position, and to keep baby high enough and close enough to mother's breast. When held in this position, a small baby may tend to curl up in a ball. The cradle position may not be the best choice if mother and baby are experiencing any problems with latch-on, milk transfer, or if the mother has sore nipples.
Diane Wiessinger, LLL Leader and IBCLC from Ithaca, New York, USA, believes that using the usual C-hold on the breast when a baby is in the cradle hold can cause problems. She uses a sandwich analogy to help explain why shaping the breast in a "sandwich hold " may help baby latch on better. "Imagine eating a very large, very thick sandwich. First the hands squeeze it a bit to create more of an oval, the long axis of the oval running corner to corner across the mouth. Fingers and thumbs form a C on each side of the sandwich, with the thumbs well out of the way to allow for a big bite. The bottom side of the sandwich is brought toward the mouth as the mandible (the lower jaw) - the working jaw - drops. The mandible is planted on the bottom of the sandwich, well back where the filling is. Only then is the sandwich swung up to let the prominent but passive maxilla (upper jaw) land on top. The asymmetry of this motion compensates for the different placements and actions of the upper and lower jaws, and results in a larger bite than would be possible with a symmetrical, fully frontal bite. A big bite requires that the sandwich be put on the tongue, which is why one cannot take a bite out of a sandwich as round and as firm as a soccer ball. Having food pushed against the tongue does not allow for it to be manipulated by the mandible; the food must land on the tongue."
She continues, "Now imagine a very big, squeezable, stationary, but suspended sandwich. If it is approached from above, the nose burrows in, and only a small bite of bread, not filling, is available because the all-important mandible (lower jaw) swings toward the chest and away from the sandwich as the chin tucks. If the sandwich is approached straight on, for a symmetrical bite, the bite is still not very large. The lips may press in rather than curling out, further limiting the size of the mouthful. To take an efficient bite from this immovable sandwich, it must first be shaped into an oval. Then it must be approached from below, starting with the nose near the sandwich stuffing. The head tips back slightly and the mandible (lower jaw) comes up and forward to fix itself well back onto the sandwich. The maxilla (upper jaw) is the last part to land on the sandwich, and it is then possible to take a large and satisfying bite."
The Breastfeeding Answer Book describes the football or clutch hold: "To get comfortable, suggest the mother put a pillow behind her shoulders and firm pillows at her side to raise the baby up to the level of her breast. The baby faces the mother while his body is tucked under her arm along her side. The baby's bottom rests on the pillow near the mother's elbow with his hips against the back of the chair, sofa, or against the wall, if she is sitting up in bed. The baby's upper back rests along his mother's forearm while she supports his neck with her hand."
The football or clutch position is a very useful position for mothers who have had a cesarean birth. It helps keep the weight of baby off mother's incision. It is also a good position for mothers with flat or inverted nipples and for babies with latch-on or sucking problems because it offers mother a better view of baby and breast and offers her better control of baby's head. The football or clutch position is a good choice for smaller babies. This position is most effective when combined with the C-hold. Unfortunately some caregivers are not familiar enough with this position to be able to teach it well. Some mothers find it is just not a comfortable position.
Alison Hazelbaker, LLL Leader and IBCLC from Columbus, Ohio, USA, finds that many people use the football hold incorrectly by combining it with the bulls-eye latch-on technique and by placing baby's mouth too far away from mother's nipple. The bulls-eye latch and asymmetric latch techniques are discussed in depth later in this article. A bulls-eye latch is one in which the nipple is centered in baby's mouth. When using an, asymmetric latch, mother aims for an off-center placement of nipple in baby's mouth so that more of the areola is covered by baby's lower jaw.
Linda Barrett, LLL Leader and IBCLC from Centerville, Ohio, USA, tells mothers that "when cross cradling, the baby is tummy to tummy with mother, supported by a pillow across mother's lap to help raise baby up to nipple level. When mother is ready to latch on baby, it is important that baby's mouth is very close to the nipple from the start. If she is planning to breastfeed on the left breast, she supports the baby with the fingers of her right hand placed loosely behind the baby's ears and neck. The baby rests in the web between the thumb, index finger, and palm of mother's hand, forming a "second neck" for baby. This helps stabilize baby's head and neck. She has the palm of her hand placed between the baby's shoulder blades. When baby opens his mouth wide, the mother pushes with the palm of her hand from between the shoulder blades not with the fingers behind the neck. This helps to bring the chin into the breast slightly before the nose, which points the nipple toward the roof of baby's mouth. As the nipple grazes the juncture of baby's hard and soft palates, it elicits baby's suck. This method also helps the baby to latch deeper onto the breast so that he can compress the milk sinuses (also called milk reservoirs) which allows for efficient milk transfer. It is important not to touch the top or back of the newborn's head because it is very sensitive after birth. When the head is touched the baby may have a tendency to pull back from mother's breast rather than move in toward the nipple. This may be the reason why some mothers have trouble getting the baby to latch on. They try to force the baby onto the breast by firmly holding the back of baby's head which causes baby to arch away from mother's breast."
Many experts recommend that mother be sure that baby is tucked around her like a comma. If it seems as though baby might have trouble breathing, all the mother has to do is pull the baby closer to her body with the elbow of the arm that is supporting baby. This changes the angle so that baby's nose remains clear. In the cross-cradle position, the U-hold is more effective for supporting the breast. (The U-hold is described later in this article.)
Jan Barger, RN, IBCLC from Wheaton, Illinois, USA, recommends that mothers use what she and Judith Lauwers, BA, IBCLC from Chalfont, Pennsylvania, USA, call the dominant hand position. They find that mothers have better control of baby and are better able to position baby well when they use their dominant hand to support baby at the breast in the early days. "In the dominant hand position, the right-handed mother supports the baby's neck with her right hand and supports his body with her forearm. She then moves her arm that is holding the baby across her body to the opposite breast. This makes it possible to begin the feed at one breast in the football or clutch position and end it with the cross-cradle hold on the opposite breast without repositioning her hold on the baby." Or mother could start with the cross-cradle position and finish with the football or clutch position.
The cross-cradle position is often recommended in the early days for babies who need extra help getting latched on well. It can be easier for the mother to latch baby on in this position because it gives her more control in guiding baby to the breast. Mother's hand creates a "second neck" for baby, thus giving baby more stabilization. This makes the cross-cradle position good for premature babies and smaller babies, and for babies with low muscle tone. Dr. Jack Newman finds this position most useful when teaching mothers the asymmetric latch.
Mary Kay Smith, LLL Leader, IBCLC, and Professional Liaison (PL) Leader from Romeoville, Illinois, USA, says she suggests a new mother use the cross-cradle hold to get baby latched on well, then slide her other arm under the baby so she finishes the feeding in the more comfortable cradle position. The mother needs to be sure she keeps the baby positioned well while she does this so she doesn't disturb his sucking.
The cross-cradle position may not work well with the bulls-eye latch. In fact, trying to use this position with the bulls-eye latch may cause problems for mothers. If a mother is taught to place her hand at the back of baby's head rather than at the neck, then she may experience problems with baby arching away from her breast. She may perceive baby's action as breast refusal when it is actually a reflex. The cross-cradle position can be uncomfortable for mother to maintain without adequate support of the arm holding baby and the arm holding the breast, especially with large babies. Encourage mother to use enough pillows for optimal support. It is very important that mother is told that the cross-cradle hold is a temporary breastfeeding position. Once she and her baby are more experienced, they can use other, more comfortable nursing positions.
Diane Wiessinger says, "The first defense I heard of the cross-cradle position was by Laura Best in 1990. She said that when a mother tenses, her supporting arm tends to move out to her side. So if she's supporting the baby in her left arm at her left breast in the cradle position, she will tend to pull him toward the left - the wrong direction for a good latch. But if she is supporting him with her right arm for her left breast, she will tend, if anything, to draw him into an even better position."
Alison Hazelbaker explains that "the cross-cradle hold supports the baby's thoracic area (upper spinal column) and thus stabilizes baby's jaw. it works well with some babies who have certain types of sensory sucking problems."
Catherine Watson Genna, LLL Leader and IBCLC from Woodhaven, New York, USA, prefers the cross-cradle hold with the asymmetric latch "for babies with recessed chins and/or babies who are tongue-tied because it allows them to get more tongue in contact with the breast. This stabilizes the tongue and decreases excessive compression of mother's breast and nipple which allows baby to get bigger mouthfuls of his mother's milk."
Claudia Morse-Karzen, an LLL Leader from Illinois, USA, has a different opinion about the cross-cradle hold. She writes: "My co-Leaders and I have had dozens of calls over the past three years that stem from problems with the cross-cradle hold. We continue to see mothers coming to our meetings using the cross-cradle hold when their babies are several weeks old and not knowing why they are having problems. One mother said, 'My arms aren't strong enough to nurse.' When we showed her how to use the cradle hold she felt instant relief from her nipple soreness. Leaders should be aware of this when a mother calls with sore nipples or baby pulling off the breast and ask if the mother is using the cross-cradle hold. Even if mothers are told by their health care providers or midwives that the cross-cradle hold is only a transitional hold, they often don't realize it is not necessary to use it long-term."
The Breastfeeding Answer Book explains: "In the side-lying position, the mother lies on her side. To get comfortable, she can put pillows under her head, behind her back, and under the knee of her upper leg. Her body is at an angle to the bed as she leans slightly backward into the pillow behind her back. The baby is on his side facing his mother with his back resting against his mother's forearm and his knees pulled in close to his mother. To keep the baby on his side facing his mother, a folded towel, a rolled receiving blanket, or a small pillow may need to be propped behind his back."
The side-lying position is helpful for mothers who are recovering from a cesarean birth or an episiotomy. This position is a good way to soothe baby to sleep and for nursing in bed. Some experts find that this is another position that works well for mothers and babies who are having trouble getting started with breastfeeding. Others feel that this position can be too challenging for new mothers. Unfortunately, this position is not always taught to new mothers in hospitals. It is rarely used in the early weeks in spite of the fact that researchers report significantly less fatigue following nursing in the side-lying position versus the sitting position. They suggest that increased emphasis on the restfulness of the side-lying position for breastfeeding may decrease postpartum fatigue and enhance breastfeeding success.
The Breastfeeding Answer Book explains. "The purpose of supporting the breast is to make it firmer for easier latch-on and to keep its weight off the baby's chin during feedings so that he stays latched-on well." Kay Hoover has noticed that sometimes a baby will not latch on due to the weight of mother's breast lying on his chest. When mother lifts her breast off baby's chest, he latches on.
The C-hold is described as supporting mother's breast with her thumb on top and her four fingers underneath. When done properly, this hold allows mother to support her breast with her fingers far enough away from her areola to avoid interfering with baby latching on. Some breastfeeding photographs of the C-hold show mother's lower fingers too close to the lower part of her areola.
Remind mother to keep her fingers well back toward her chest wall. This hold allows mother to support her breast comfortably. It is a good breast hold to use with the football or clutch position or the side-lying position because it allows the alignment of the oval of breast tissue to match the position of baby's mouth. The long axis of the oval goes corner to corner in baby's mouth. This allows baby to get a larger mouthful of breast. When the C-hold is used with the cradle or cross- cradle positions, the improper alignment of this oval to baby's mouth can make it harder for baby to latch on well. This is like holding a sandwich vertically while you try to take a bite out of it holding your mouth horizontally.
Diane Wiessinger describes the U hold in this way: "To shape and stabilize her left breast, the mother can start with her left hand flat on her ribs, under her breast, with her index finger in the crease under her breast. If she now rotates her hand, her thumb will be on the outer aspect of her breast with her fingers on the inner aspect. Her breast will rest in the U formed by her thumb and index finger."
The U-hold helps keep mother's fingers behind her areola so that they do not interfere with baby's latch. it allows mother to support her breast comfortably. It is extremely useful when holding baby in the cradle or cross-cradle position because it allows the alignment of the oval of breast tissue to match the position of baby's mouth. The long axis of the oval goes corner to corner in baby's mouth. This helps ensure baby gets a larger mouthful of breast. When the U-hold is used with the football (clutch) position or the side-lying position, the improper alignment of this oval to baby's mouth can make it harder for baby to latch on well.
Norma Ritter, LLL Leader, PL Leader, and IBCLC from Big Flats, New York, USA, explains that "when using the U-hold the mother does not have a thumb on top of the breast. This eliminates the possibility that mother will be tempted to press down on the breast 'to let baby breathe,' which inadvertently moves the nipple within baby's mouth so that the latch is no longer optimal and he is 'cliff-hanging' off the end of mother's nipple."
In the scissors hold, mother supports her breast by holding it between her index finger and middle finger. Many books discourage this way of supporting the breast because it can be very tricky for a mother to keep her fingers far enough away from the areola to avoid interfering with baby's latch. Mothers with long fingers may be able to use this hold successfully.
When baby is latching on to mother's breast, it is very important that baby is held close to the breast. Diane Wiessinger explains that "a newborn nursing vigorously at a newly lactating breast will probably show nothing but an upper lip and fat cheek. His cheek will press against the breast so that his wide mouth is hidden. One of the questions that I ask when working with new mothers is 'Are baby's lips flanged out?' if she answers right away, I tell her to try pulling baby closer. To be able to see that easily and answer me so quickly tells me that baby is not close enough to her breast."
Babies often give feeding cues before they start crying. A mother may find it easier to try to nurse baby when he is wriggling, moving his arms around his head, bringing his hands to his mouth, or making sucking movements with his mouth. If mother waits until baby is actually crying, she will have a much harder time getting baby to nurse, especially in the early days.
Dr. Jack Newman encourages mothers, once their milk becomes abundant, to watch for the "open mouth wide - pause - close mouth" type of sucking motion as one way to tell if baby is latched on well and swallowing large mouthfuls of milk. Carol Brussel, IBCLC and former LLL Leader from Denver, Colorado, USA, explains, "the baby gets on and does a series of quick sucks and then stimulates mother's let- down. With the let-down, baby's mouth seems to widen even more on each suck. When baby's chin is at the lowest point there is a slight pause as I hear baby swallow, and then baby's mouth closes."
Although some breastfeeding books recommend mothers use firm pressure on a baby's chin to help him open his mouth wider, this may actually cause a baby to clench and may cause injury. Pressing down firmly on baby's chin is a therapeutic technique used with babies who have certain types of neurodevelopmental problems and is not recommended for normal, healthy full-term babies.
With the bulls-eye latch-on technique, a mother is encouraged to tickle the baby's lips to stimulate the rooting reflex. She then waits for the baby to open his mouth wide, centers her nipple in baby's mouth, and brings baby quickly and gently to her breast using rapid arm movement (RAM) as first described by Chele Marmet and Ellen Shell, both LLL Leaders and IBCLCs from Los Angeles, California, USA.
The bulls-eye latch-on technique is taught in most breastfeeding books, classes, and support group meetings. Many Leaders and other breastfeeding helpers are very familiar with this technique and have been recommending it successfully for years.
Unfortunately, the bulls-eye latch-on technique can make it difficult for some babies to get a large enough mouthful of breast so that they can compress the milk sinuses (also called lactiferous sinuses or milk reservoirs) and effectively remove milk from mother's breast. Barbara Wilson-Clay, IBCLC and former LLL Leader from Manchaca, Texas, USA, explains that "the moveable parts of the infant's skull are the lower jaw and the tongue. These must grip and compress the lactiferous sinuses that lie under the areola. If the nipple is centered in the baby's mouth the jaw closes too close to the nipple, pinching and distorting the shape of the nipple when baby comes off.
With the bulls-eye latch-on technique, babies commonly tuck in their lips which causes mother pain. This technique may not be effective at all when it is used with the football (clutch) position or in the cross- cradle position.
Maureen Minchin, MA, IBCLC from Victoria, Australia, feels that "there are particular problems likely with any nursing position if the person helping the mother is focused on the position itself and not on the outcome and the quality of the mouthful of breast achieved by baby in that position." Dr. Jack Newman firmly believes that "even more mothers and babies will have an easier time of it if the baby comes to the breast and latches on asymmetrically, covering more of the areola with his lower lip than his upper lip."
In their book The Breastfeeding Atlas, Kay Hoover and Barbara Wilson-Clay write, "The trick of helping the baby latch onto the breast rather than the nipple is to remember that it is the orientation of the lower jaw that is the key. The upper jaw is immobile, providing only counterpressure. The hinge-like opening and closing of the lower jaw and the massaging action of the tongue against the breast alternate to create the positive and negative pressure needed to remove milk. Therefore, it is essential that the lower jaw be correctly placed. Mothers should aim for an off-center placement of the baby's mouth on the areola with much more of the 'target' being covered on the chin side. This positions the jaw closure over the milk sinuses and prevents nipple pinching."
They continue to discuss how to enable the baby to open his mouth wide. "It requires drawing the baby's body in close, so that the chest, stomach, and knees are touching the mother's body in a 'wrap-around' fashion. The baby's body is placed with the baby's nose opposite the mother's nipple, so that the baby begins the latch-on sequence needing to reach for the nipple. This forces the baby to open wide. The head should be allowed to tip back slightly. Minor extension of the head results in the lower jaw approaching and being placed on the breast first. If instead, the mother pushes on the baby's head, it will flex forward, and the nose and upper jaw will make first contact with the breast. This is like trying to bite an apple with your chin tucked into your chest."
The asymmetric position allows baby to get a large mouthful of breast. It helps keep baby's lips flanged out. As mother brings baby to the breast leading with the chin, when the breast comes into contact with baby's tongue, she can use it to help encourage him to open a little wider. Baby's upper lip is the last part of baby that touches the breast. Alison Hazelbaker explains that "the asymmetric latch helps facilitate proper placement of baby's tongue on mother's breast. When baby's chin is placed well and baby has proper tongue placement, baby's lips flange automatically."
Many mothers find that when they use the asymmetric latch technique, any nipple pain that they had been experiencing disappears. In several cases, I have helped mothers who had sore nipples. When their nipples came out of their babies' mouths, they were misshapen with obvious compression stripes. When I showed these mothers the cross-cradle position using the U-hold for breast support and the asymmetric latch technique, they were able to get their babies latched on much better. When their nipples came out of babies' mouths, they were shaped normally. The babies nursed more effectively and got more milk and the mothers' nipple pain disappeared.
In the preface of her book Breastfeeding: A Guide for the Medical Profession, 5th Edition, Ruth Lawrence cautions, "The field [of human lactation] has moved from a dogma of rules about breastfeeding that demanded rigid schedules, and specific managements through a brief period in which thoughtful contemplation and recognition of the variability of the human condition were recognized. Well-timed, skilled clinicians recognized the value of flexibility and individualizing care. Once again, however, ritual and protocol are being enforced. The Baby Friendly approach, whose very being was spawned to set us free from rigid dictums, is requiring protocols and policies. Mothers tell us they cannot breastfeed because there are too many rules. Medicine, itself in the era of managed care, has come forth with care guidelines for one disease or circumstance after another. Will breastfeeding be next?"
Rules and regulations have no place in the mother-baby relationship. Each mother and baby dyad is different and what works well for one mother and baby may not work well for another mother and baby. The important thing to do is to look at the mother and baby as individuals.
Laure Marchand-Lucas, MD, LLL Leader, Administrator of PL Resources for LLLI's International Division, and IBCLC from Paris, France, reminds us that "a baby who hasn't been too disturbed will by himself or herself find its way to the best position which my vary according to its own mouth conformation and the mother's breast, nipple, and areola conformation. All the trouble begins when the baby has 'lost' the 'instructions for use' because of the interventions at birth or for some other reason." These sentiments are reinforced by the research done by Dr. Lennart Righard on the effect of delivery room routines on the success of the first breastfeed and illustrated in his video Delivery Self-Attachment.
As you can see, there are many pieces to this dance of positioning and latch-on that occurs between mothers and babies. It is important for Leaders to share information with mothers about all the various nursing positions, breast holds, and latch-on techniques. With support and knowledge, Leaders can empower mothers to choose what works best for them and their babies. Trust mothers to choose wisely. Help mothers recognize babies' cues. Reminding each mother that she knows her baby best supports the bond between mother and baby. Respecting the mother and trusting her to choose what works best for her and her baby while supporting and encouraging the mother-baby relationship is at the heart of La Leche League philosophy.
Gotsch, G. BREASTFEEDING PURE AND SIMPLE. Schaumburg, Illinois: La Leche League International, 2000. La Leche League International. Positioning your baby at the breast. Schaumburg Illinois: La Leche League International, June 1996. Publication No. 304-17 La Leche League International. THE WOMANLY ART OF BREASTFEEDING. Schaumburg, Illinois: La Leche League International, 1997. Meintz-Maher, S. An Overview of Solutions to Breastfeeding and Sucking Problems. Schaumburg, Illinois: La Leche League International, 1988. Mohrbacher, N. and Stock, J. BREASTFEEDING ANSWER BOOK, Revised Edition. Schaumburg, Illinois: La Leche League International, 1997.
Black, R., Jarman, L., and Simpson, B. Lactation Specialist Self-Study Series Module 2: The Process of Breastfeeding. Sudbury, MA: Jones and Bartlett Publishers, 1998. Hazelbaker, A.K. Skills and Techniques for Lactation Consultant Practice. Independent Study Module 3. Columbus, OH: Self-published, 1999. Hoover, K. Latch-on difficulties: a clinical observation. J Hum Lact 2000; 16(1):6. Huggins, K. The Nursing Mother's Companion, 3rd revised edition. Boston, MA: Harvard Commons Press, 1995. Lauwers, J. Counseling the Nursing Mother, third edition. Boston, MA: Jones and Bartlett Publishers, 2000. Lawrence, R. Breastfeeding: A Guide for the Medical Profession, 5th edition. St. Louis: Mosby, 1999. Marmet, C., and Shell, E. Lactation Forms: A Guide for Lactation Consulting Charting. Encino, CA: Lactation Institute, 1986. Milligan, R.A., Flenniken, P.M., and Pugh, L.C. Positioning intervention to minimize fatigue in breastfeeding women. Appl Nurs Res 1996; 9:67-70. Minchin, M. Breastfeeding Matters, 4th Revised Edition. Australia: Alma Publications, 1998. Newman, J. and Pitman, T. Dr. Jack Newman's Guide to Breastfeeding. Canada: HarperCollins Ltd., 2000. Renfrew, M., Fisher, C., and Arms, S. Bestfeeding: Getting Breastfeeding Right for You. Berkeley, CA: Celestial Arts Press, 1990. Renfrew, M.J., Lang, S., Martin, L., and Woolridge, M. Interventions for improving breastfeeding technique. Cochrane Database Syst Rev 2000; 2:CD000041. Renfrew, M. Positioning baby at the breast: more than a visual skill.J Hum Lact 1989; 5(1)13-15. Righard, L. and Alade, M. Effect of delivery room routines on success of first breast-feed. Lancet 1990; 336:1105-1107. Righard, M. Video: Delivery Self Attachment, copyright 1992, Geddes Productions. Riordan, J and Auerbach, K. Breastfeeding and Human Lactation, 2nd edition. Boston: Jones and Bartlett Publishers, 1999. Riordan, J. A Practical Guide to Breastfeeding. Boston, MA: Jones and Bartlett Publishers, 1991. Sears, M. and Sears, W. The Breastfeeding Book, Boston, MA: Little, Brown and Company, 2000. Tamaro, J. So That's What They're For! Breastfeeding Basics. Holbrook, MA: Adams Media Corporation, 1996. Wiessinger, D. A breastfeeding teaching tool using a sandwich analogy for latch-on. J Hum Lact 1998; 14(1):51-56. WiIson-Clay, B. and Hoover, K. The Breastfeeding Atlas. Austin, TX: LactNews Press, 1999.
Newman, J., and Barnes, A. "When Latching." Wiessinger D. "New Thoughts on Positioning."
Jan Barger, RN, MA, IBCLC Linda Barrett, IBCLC, APL Ohio Carol Brussel, BA, IBCLC K. Jean Cotterman, RNC, IBCLC Catherine Watson Genna, BS, IBCLC Alison K. Hazelbaker, MA, IBCLC Kay Hoover, Med, IBCLC Laure Marchand-Lucas, MD, IBCLC Maureen Minchin, MA, IBCLC Claudia Morse-Karzen, LLL Leader Jack Newman, MD Norma Ritter, IBCLC, APL New York State West Linda J. Smith, BSE, FACCE, IBCLC Melissa Vickers, Med, IBCLC, Online PL Resource Leader Diane Wiessinger, MS, IBCLC, AAPL New York State West Barbara Wilson-Clay, BS, IBCLC
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Allspice Leaf Oil Angelica Oil Anise Oil Baobab Oil Basil Oil Bay Laurel Oil Bay Oil Benzoin Oil Bergamot Oil Black Pepper Oil Chamomile (German) Oil Cajuput Oil Calamus Oil Camphor (White) Oil Caraway Oil Cardamom Oil Carrot Seed Oil Catnip Oil Cedarwood Oil Chamomile Oil Cinnamon Oil Citronella Oil Clary-Sage Oil Clove Oil Coriander Oil Cypress Oil Dill Oil Eucalyptus Oil Fennel Oil Fir Needle Oil Frankincense Oil Geranium Oil German Chamomile Oil Ginger Oil Grapefruit Oil Helichrysum Oil Hyssop Oil Iris-Root Oil Jasmine Oil Juniper Oil Labdanum Oil Lavender Oil Lemon-Balm Oil Lemongrass Oil Lemon Oil Lime Oil Longleaf-Pine Oil Mandarin Oil Marjoram Oil Mimosa Oil Myrrh Oil Myrtle Oil Neroli Oil Niaouli Oil Nutmeg Oil Orange Oil Oregano Oil Palmarosa Oil Patchouli Oil Peppermint Oil Peru-Balsam Oil Petitgrain Oil Pine-Long Leaf Oil Pine-Needle Oil Pine-Swiss Oil Rosemary Oil Rose Oil Rosewood Oil Sage Oil Sandalwood Oil Savory Oil Spearmint Oil Spikenard Oil Swiss-Pine Oil Tangerine Oil Tea-Tree Oil Thyme Oil Vanilla Oil Verbena Oil Vetiver Oil Violet Oil White-Camphor Oil Yarrow Oil Ylang-Ylang Oil Aromatherapy
Healing Baths For Colds
Herbal Cleansers
Using Essential Oils
Almond, Sweet Oil Apricot Kernel Oil Argan Oil Arnica Oil Avocado Oil Baobab Oil Black Cumin Oil Black Currant Oil Black Seed Oil Borage Seed Oil Calendula Oil Camelina Oil Castor Oil Coconut Oil Comfrey Oil Evening Primrose Oil Flaxseed Oil Grapeseed Oil Hazelnut Oil Hemp Seed Oil Jojoba Oil Kukui Nut Oil Macadamia Nut Oil Meadowfoam Seed Oil Mullein Oil Neem Oil Olive Oil Palm Oil Plantain Oil Plum Kernel Oil Poke Root Oil Pomegranate Seed Oil Pumpkin Seed Oil Rosehip Seed Oil Safflower Oil Sea Buckthorn Oil Sesame Seed Oil Shea Nut Oil Soybean Oil St. Johns Wort Oil Sunflower Oil Tamanu Oil Vitamin E Oil Wheat Germ Oil
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In school, I was taught that George Washington could not tell a lie, but I never knew that he owned more than 300 slaves.
I learned that lesson in December, when I visited the new President's House and its exhibit, "Freedom and Slavery in Making a New Nation," on Independence Mall. The open-air installation was built with brick foundation walls and framing to resemble the mansion in which Presidents Washington and John Adams lived and conducted the business of the new nation when Philadelphia was its capital.
The site honors the location and importance of the original mansion, but it also addresses the subject of slavery in early U.S. history. Gary B. Nash, a professor emeritus of history at UCLA, and the lead historian for the exhibit, said, "A whole cloud of historical amnesia is going to be swept away. This story speaks to the themes of the Liberty Bell … [which] connects to liberty and slavery being conjoined at our nation's birth."
At the President's House, I learned that Philadelphia had the largest free black population of any city in the 13 original states, and that a law permitted any slave residing in Pennsylvania for more than six months to petition for his or her freedom. The moment a slave left the state, however, the six-month period began anew.
The George Washington revealed in the exhibit circumvented that law by dispatching the nine slaves he kept at the mansion on brief errands to New Jersey or to Mount Vernon. It was also at the mansion that he signed the Fugitive Slave Act of 1793 that gave owners the right to recover runaway slaves in another state. Yet Washington appeared conflicted about slavery, and he directed in his will that his slaves be freed after his wife Martha's death.
The original President's House was demolished in 1832, but a large glass vitrine at the center of the stie displays fragments of the foundation, kitchen and a bay window that were unearthed during an archeoligical dig in 2007. Washington had added the window to the mansion, and it became the model for the one in the oval office at the White House.
The bone-chilling temperature and low winter sun contributed to the exhibit's somber mood. A granite wall is etched with the names of Washington's slaves who worked and lived at the mansion — Austin, Christopher, Giles, Hercules, Joe, Moll, Oney Judge, Paris and Richmond — and five motion-activated video screens, mounted above the brick fireplaces, tell their compelling stories. I was captivated by the tale of Oney Judge, a 17-year-old slave who fled before Martha could ship her to Mount Vernon as a wedding present for Eliza Custis, her granddaughter.
The remaining slaves never escaped Philadelphia. However, Hercules, Washington's prized chef at President's House, did escape from Mount Vernon in 1797.
Across the street at the National Constitution Center, I voted for Abe Lincoln as my favorite president. George Washington currently has the most votes, but I wondered if he would remain everyone's favorite.

subset: commoncrawl


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New Straits Times / May 9, 2007
New Straits Times - Aug 8, 2007
Intelligence agents arrested the suspects in Tehran, Kerman, Bushehr, and some other provinces after several plaintiffs filed complaints against the company, an Intelligence Ministry official in charge of combating pyramid scam companies announced on Saturday, the Tehran Times reported.
The company had been active in cyberspace under the guise of e-trade and investment in international stock markets, oil and gold markets, advanced industries, and arms sales.
"They robbed people and then closed down their website. As a result of follow-ups by the ministry's agents, the main members of the network were identified and arrested," the official added.
The official also said some companies, which claim they have obtained official certification permits to run marketing activities via the Internet, have not been granted permits.
In January, the Intelligence Ministry announced that 15 companies involved in pyramid schemes had been identified and forced to discontinue operations in Iran.
Palinure, Inviting, Golden Village, FSG, Griffin and Gold Quest were some of the companies that were shut down in Iran.
The source recalled that after the closure of over 410 offices of the pyramid company Gold Quest in Tehran, a large number of the leaders of the company said they were ready to halt their activities and somehow satisfy the people who had lost their money by investing in the fake company.
Gold Quest is a global network marketing company that claims to be engaged in selling coins and watches that are said to have numismatic value.
Network marketing companies work on the principle of the pyramid scheme, a non-sustainable business model that involves the exchange of money primarily for enrolling other people into the scheme.
Network marketing differs from pyramid selling (pyramid schemes) in that the latter is a financial fraud and those who deal in this kind of business can be prosecuted based on a relevant law ratified in 2006, which imposes a ban on the activities of pyramid selling companies in Iran.
According to the law, everyone who cooperates with these companies is disrupting the economic system of Iran and is legally responsible.
Gold Quest, believed to be involved in one of the largest economic corruption cases in Iran's history, was banned in by Iran in 2005. Prosecutors found the pyramid company's activities have led to the exit of half a billion dollars from Iran.
Pyramid schemes have been banned in many other countries, including the United States, Great Britain, France, Canada, Malaysia, Norway, Australia, New Zealand, Nepal, and Sri Lanka.
Ponzi scheme victimizes thousands in Turkey
(Reuters) - Securities regulators in the Canadian province of Alberta said on Thursday that Gold-Quest International Inc was a classic Ponzi scheme that bilked investors out of $29 million with the promise of sky-high returns from foreign currency trading.
(Reporting by Scott Haggett; editing by Rob Wilson)


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Not sure what to search for?click here to find out more
Each Laguiole knife is subjected to a special firing process, providing ultimate blade flexibility and a long lasting, perfect cut.
Select a colour:
It looks like you are in United States. Click here to stay in United States or click here to continue to Portugal.


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Jennifer Nettles and Kelly Clarkson 'Duets' Partners Revealed
'Duets,' the new reality singing competition series starring Sugarland vocalist Jennifer Nettles and semi-country singer Kelly Clarkson, debuts this coming Thursday (May 24) in a two-hour premiere. The premise of the show is that established vocalists will partner with neophytes for –you guessed it- a duet! Rather than be judges or mentors, the celebs are performing alongside the hopefuls. Ahead of the big bow at 8 PM ET, the singing partners of each mentor have been revealed by ABC.
Nettles will perform with John Glosson, a 32-year-old from Douglas, Georgia. She's a Georgian, so based on that fact alone, this is likely a smart pairing. She will also sing with J Rome, 25, from Laurel, Maryland.
Clarkson has been teamed up with Jason Farol, 23, from Torrance, Calif., and with Jordan Meredith, a 21-year-old from Wisconsin. You can peruse the ABC site to get a sneak peek of and a feel for the partners.
Together, the superstars and their partners take the stage each week and perform in front of a live studio audience. In the end, only one duet will be chosen as the "winner." Up for grabs is a contract with Hollywood Records. Not too shabby, huh?
Be sure and tune in this Thursday to hear the sweet sounds that Nettles and Clarkson make with their partners.


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If you've decided to keep the business running – or if you just want to see how it goes – it's important to be realistic about what you can do.
It will help to get as much information as you can about your cancer and the possible effects its treatment may have on you. You'll also need to be realistic about your business demands and your finances.
You can get a lot of advice and information for free or at a low cost from the following places:
- your local authority (council)
- your local Jobcentre, or if you live in Northern Ireland, your Jobs and Benefits Office
- disability support organisations
- your local Law Centre
- your local Citizens Advice
- a financial adviser or your bank
- your chamber of commerce or other local business networks
- your trade union or professional association, if you belong to one
- the government and services website at gov.uk in England, Scotland and Wales, or nidirect.gov.uk in Northern Ireland.
If you have professional advisers, like an accountant or a lawyer, this is a good time to ask for their guidance.


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10497 posters & still counting!
to the amazing universe of Film posters! For us a form of art on its own right! An endless world of adventures, weird creatures, lonely cowboys, evil invaders, mad scientists and pleasures of the flesh! Images from worlds beyond the barriers of time, paintings that meant to tease and promote a movie.
Some say that Film Posters have an expire date, that are supposed to exist for just a few days or weeks until the movie they promote is out of the theater. Well, no! There are thousands of us out there who preserve the culture (or shall I say the cult?) of film posters. We see them as unique art forms that have significant cultural value. As works that can remain eternal... no wonder why sometimes a poster is so much better than the actual film!
Although we really like all kinds of movies, we have a tendency towards the sci-fi, horror, cult, exploitation and weird genres. However, here you will find all styles from drama and comedy to westerns and all time classics! Everything is welcome.... so don't get surprised when you see a Disney family cartoon next to a never - heard of - cheap horror flick! We like em all but we do have our favourite dark vices.
Feel free to browse through our galleries and place your comments on the posters or on the actual films.
Cameraman and Director of Photography in Chicago and Milwaukee
The greatest Quotes from goodfellas. Check them out.
Best wedding umbrellas online. Check them out.
wanna know when we update the site with new posters? follow us
TOS. All images used in the spirit of publicity and remain the property of their respective owners. No rights given or implied. This website is a place to showcase the wonderful art of film posters. It serves as a reference point for educational and recreational purposes.


text: First week is over, and Nighthold is cleared as planned. Long fights are usually tedious and repetitive but in my opinion Gul'dan is an exception. The three phases were different enough to make this probably my favourite fight in Nighthold. Next week we start on the real stuff. Good job this week everyone!


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Think about a football team that scrimmages all year but ends the season never playing a game. Imagine an orchestra that practices for nine months but ends their year never holding a concert. Think of an artist who paints all year in her studio but never exhibits her work in a gallery.
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Maria Creech necesitaba un nuevo diseño de página web y lanzó un concurso de diseño en 99designs.
Un ganador ha sido elegido entre 107 diseños de 18 diseñadores freelance.
Feather River Pediatric Dentistry
featherriverpediatricdentistry.com will be the domain
They are a dentistry office that specializes in children's care.
Dr Crutchfield graduated from a top dental school and is experienced the the newest techniques. This site should reflect that with an intelligent design that is fresh and modern.
For more information please see attachments.
Parents of children.
We would like a layered Photoshop file so that coding can be done easily.
I have uploaded marketing materials currently being used by Feather River, they really like these designs and would like a site that is fitting with these materials.
Please help us see the vision of the home page and what a sub page might look like.
Thanks so much for your time and efforts!
There is not an existing website.
They are going to be using content from this site: http://rocklinkidsdentist.com/
They do not like the design of Rocklin Kids Dentist but they do like the content.


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You are here: Home / Archives for rachael ray saute pan
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Thanks for stopping by to visit our Only Cookware blog. We love trying out different cookware and our goal with this blog is to provide you with in-depth reviews on cookware sets, individual cookware and kitchen accessories. Read more...


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We tell powerful, inspiring stories through photography and offer a behind-the-scenes look at emerging and established photographers.
If you'd like your work to be considered, please e-mail us. You can also follow us on Twitter.
- 11 - 23 - 12
Photographer Adam Ewing took portraits of Richmond residents who had groomed their head and facial hair for their roles as extras in Steven Spielberg's "Lincoln." The clothing, poses, and style of the portraits mix modern and 19th century aesthetics.
Filed Under:Adam Ewing • Entertainment • Lincoln • Portraits • U.S.


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Caylin and D.H. • InContrast Images
|Caylin & DH|inContrast Images|
"I hardly know where to begin! I figure there is no better place to start than with one of our absolute favorite weddings from last year that we never got around to blogging: Caylin & D.H.'s wedding at The Mast Farm Inn! Love this couple. Love this location. Love even more that the whole day was jam-packed full of love!"
inContrast Images • we are a north carolina based photography team bringing a fresh, fun approach to wedding + lifestyle portrait photography. we believe in capturing real, spontaneous moments + emotions rather than stiff everyday poses + staged scenes. our photojournalistic approach combined with our background in commercial photography plays a big part in creating our unique blend of artistic storytelling with an editorial feel. we can't wait to get to know you + tell your story through our photographs. YOUR LIFE. YOUR STORY. OUR PASSION.
For More Information
FaceBook • www.facebook.com/incontrastimages
FaceBook • www.facebook.com/media/
WebSite • www.incontrastimages.com
Blog • www.incontrastimages.blogspot.com


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|6.27 / 10
|November 17, 2017
|Zack Snyder
|Charles Roven, Deborah Snyder, Geoff Johns, Jon Berg
|Warner Bros. Pictures
|Ben Affleck, Henry Cavill, Amy Adams, Gal Gadot, Ezra Miller, Jason Momoa, Ray Fisher, Jeremy Irons, Diane Lane, Connie Nielsen, J.K. Simmons, Joe Morton, Ciarán Hinds, Amber Heard
|120 minutes
write a review |
read reviews
| watch the
Justice League
A malevolent ancient enemy Steppenwolf (Ciarán Hinds), an eight-foot-tall warrior from the world of Apokolips, a dimension outside of time and space sets his sights on Earth when he realizes Superman (Henry Cavill) no longer poses a threat.
In light of Superman's ultimate sacrifice, Bruce Wayne (Ben Affleck) vows to do all he can to fight off this powerful foe. He enlists help from Diana Prince (Gal Gadot) to find and recruit a team of metahumans that includes Cyborg (Ray Fisher), Aquaman (Jason Momoa) and The Flash (Ezra Miller) in addition to Wonder Woman and Batman to stand against this terrifying threat.
But despite the formation of this unprecedented league of heroes, it may already be too late to save the planet from Steppenwolf, the nephew of the powerful supervillain Darkseid. A member of Darkseid's Elite, Steppenwolf, along with his Parademon forces, has returned to Earth on his uncle's behalf to gain the power to rule the universe.
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This is bad. And gross. And horrible. Why, why the hell would anyone smoke anything out of this alien facehugger bong?
I can only imagine all kinds of deadly accidents happening, from a panic attack kicking in and triggering death by self-asphyxia to a passerby friend who just had acid smashing a hammer over your face. Not even Adam Frucci would use this. [Twitter]


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Hawkhurst, United Kingdom – Designed for anyone with forgetful family members or busy friends, Redwood Apps today introduces iRemindU, the innovative new way to remind people of important events without hassle or nagging. The free app for iPhone and iPad sends handy reminders to anyone with an email address. Reminders can be easily added to the calendar so recipients won't forget important anniversaries, appointments, or "to do" items.
Ideal for the little things in life, iRemindU is more reliable than sending a text message that can easily be lost or forgotten. The app works seamlessly with Apple's Reminder app, so reminders can add geo-location, change the time, and sync between a Mac, iPhone, iPod touch and iPad. Senders can even see if the reminder was read and accepted or sneakily deleted.
"iRemindU is the only app that lets you send reminders and tasks TO friends and family," said Julian Sawyer, Director of Redwood Apps. "It's a great way to remind others to get things done without looking like you're nagging them (too much)."
After downloading iRemindU, people quickly find many ways to use the app that make their lives easier. Now, roommates will remember to buy milk, spouses won't forget to take out the trash, and coworkers won't be late for meetings. After seeing how complicated other reminder apps can be, creators of iRemindU designed the app to be simple and intuitive. Users log in using their Facebook account and can quickly create a reminder just by entering the text and a due date.
Recipients do not need to have iRemindU – reminders can be sent to anyone with an email address. If the app is installed, they will receive reminders instantly using notifications. Once accepted, the item will automatically be added to their Apple Reminders app. The reminder can then be edited, synced, and managed the same as any other calendar item. If the recipient does not have iRemindU, they receive an email with the reminder along with an invitation to download the app for free.
"iRemindU is the newest and most innovative reminder app available on the App Store," said Daphne Henderson, Marketing Executive for Redwood Apps. "You'll never forget to do something important again – and neither will your family or friends."
iRemindU also sets itself apart from other apps with the helpful support it offers. Users with questions about the app can use the dedicated forum on the Redwood Apps website to find answers from other users or experts.
Features of the iRemindU app include:
* Send Free Reminders – Remind others of important appointments and tasks
* Quick and Easy – Creating and sending reminders is simple
* Add to Calendar – Seamlessly works with Apple's Reminder app
* Share With Anyone – Send to friends and family even if they don't have the app
* Support – Get help in the dedicated support forum from users and experts
Device requirements:
* iPhone, iPod touch, and iPad
* Requires iOS 6.0 or later
Pricing and availability:
iRemindU 1.0 is currently available worldwide through the App Store in the Productivity category for free.
Redwood Apps
iRemindU 1.0
Download From iTunes
YouTube Video
App Icon
Based in the United Kingdom, Redwood Apps is passionate about building beautiful apps for iPhone, iPad and iPod touch. They are committed to bringing the most unique and innovative apps to the market, always with the intention of giving the user the best experience possible. Redwood is powered by users' ideas as they believe that the best ideas come from the users themselves. With their expert team of developers and top notch marketing team, they are on hand to make ideas into the best apps they can be. Copyright (C) 2012 Redwood Apps. All Rights Reserved. Apple, the Apple logo, iPhone, iPod and iPad are registered trademarks of Apple Inc. in the U.S. and/or other countries.


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Catalogs as the New Window Displays
If your favorite catalog looks more like the Sports Illustrated swimsuit edition or even an issue of Life magazine, there's a good reason. These high-end photo displays and glossy spreads help retailers sell products online. Retailers are pouring more money into catalog design, including expensive photo shoots, because they find this drives online and in-store sales. Catalogs and other hard copy advertising act as bait to lure the customer into online or brick-and-mortar shopping.


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English Department
This site has been created to provide information about the English Department at Shoreline Community College. There are so many ways to explore and develop your program of study. While faculty members are available for advising for those majoring in English, this site will offer some useful information as well.
Areas of Study
The English programs at Shoreline Community College can be viewed in four categories: Literature, Creative Writing, Composition, and Developmental English.
Transfer Degree: Associate of Arts Degree (General Transfer)
Transfer Planning Guides | Homepage | Course Descriptions | Class Schedule
Designed to provide students with a broad liberal arts background of study during their first and second years of college. The state's two-year and four-year schools developed transfer agreements that allow students from a community college to transfer at least 90 credits (60 semester credits) to a four-year college or university. The degrees satisfy some - or all - general requirements for a bachelor's degree.
Meet your departmental faculty and staff virtually, and find out more about their professional backgrounds.


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|writePatchSet is like patchSetToRepository, except that it doesn't touch the working directory or pristine cache.
|Gets the unrecorded changes in the given paths in the current repository.
|This fuction is unsafe because it accepts a patch that works on the tentative pending and we don't currently track the state of the tentative pending.
|patchSetToRepository takes a patch set, and writes a new repository in the current directory that contains all the patches in the patch set. This function is used when 'darcs get'ing a repository with the --to-match flag and the new repository is not in hashed format. This function does not (yet) work for hashed repositories. If the passed DarcsFlags tell darcs to create a hashed repository, this function will call error.
A PatchSet is in reverse order, plus has information about which tags are clean, meaning all patches applied prior to them are in the tag itself, so we can stop reading at that point. Just to clarify, the first patch in a PatchSet is the one most recently applied to the repo.
PatchSets have the property that if (info $ last $ head a) == (info $ last $ head b) then (tail a) and (tail b) are identical repositories
Does this mean that in a patch set such as [[a b t1 c d e t2][f g t3] [h i]], t1, t2 and t3 are tags, and t2 and t3 are clean?
Can we have PatchSet with length at least 3? Florent
|Sets scripts in or below the current directory executable. A script is any file that starts with the bytes '#!'. This is used sometimes for --set-scripts-executable, but at other times --set-scripts-executable is handled by the hunk patch case of applyFL.
|Produced by Haddock version 2.4.2


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Thousands of people will be able to receive free, confidential citizenship and immigration information this week thanks to the New York Daily News and City University of New York's 12th Annual Citizenship NOW! hotline.
Running from Monday,April 28, through Friday, May 2, between 9 a.m. and 7 p.m., the hotline has more than 400 trained volunteers who can answer questions in English and Spanish as well as many other languages, such as Mandarin, Cantonese, Korean, Russian, Bengali, Haitian Creole, French, Italian, Polish, Yiddish and Arabic.
In partnership with Univision and WABC-TV, the weeklong event includes on-air promotional announcements, live coverage and special news segments.
The largest program of its kind in the country, Citizenship NOW! was launched in April 2004 to address the lack of access to information about immigration.
Since its inception, nearly 124,000 callers have sought information from the call-in.
The Citizenship NOW! hotline is led by attorney Allan Wernick, who is also a professor of Law at Baruch College and writes the twice-weekly "Immigration" column for the Daily News. Additionally, Wernick writes the nationally syndicated column, "Immigration and Citizenship" and is the director of the CUNY Citizenship Now! project.
"With immigration reform stalled in Congress, the Daily News/CUNY Citizenship NOW! call-in is of special importance this year," Wernick said. "Volunteers will provide callers with information on how immigrants can qualify for legal status and U.S. citizenship under existing laws. Immigrants can't wait for Congress, they need help now."
To reach the hotline, call 646- 746-9636 for English,646-746-9634 for Spanish and 212-221-2419 for the TTY number.


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by Pete Mazzaccaro
It took more than a year after the death of Elizabeth Bales' best friend, Dr. Teresa Garofalo, before she could really begin to talk about it.
"I'm still a wreck," she said in a recent interview with the Local.
Bales met Garofalo at their interviews for admission to veterinary school in 1996. Garofolo had left runway modeling to be a veterinarian. She was, Bales said, a tremendously optimistic and generous person, full of energy and life.
"We became instant friends," Bales said.
In August of 2010, Garofalo died of complications from acute myeloid leukemia, a bone marrow disorder in which abnormal white blood cells accumulate in the bone marrow and prevent the production of normal blood cells.
"Her treatment lasted a little more than three years," Bales said. "I got to spend a lot of those days with her. A lot of those days were great fun. Others were very hard. I learned a lot about her and about the value of life."
Bales, a Hill resident – same may remember her from five years she spent as a veterinarian at the Chestnut Hill Cat Clinic – joined the Chestnut Hill Community Association last year, she said, looking for a project that would bring the community together. The CHCA's annual blood drive, which will take place on Saturday Feb. 11, seemed like a perfect opportunity to not only accomplish that goal, but also to honor her friend.
"In the course of her treatment, Garofalo needed 400 units of blood," Bales said. " When she was dying, friends asked her what we could do to honor her. She said the most important thing for her was to give blood back to the community."
Bales' goal is to try and raise 400 units of blood. It's no small task. The annual blood drive typically nets between 45 and 65 units of blood on any given year. Bales, however, is confident that a real community effort could accomplish the goal.
"This is a really remarkable community when it comes together," Bales said. "We're all better served when we come together for a project like this that will benefit the community."
Bales and her co-chair, Jay Valinis, have received a helping hand from a number of area businesses, including The Chestnut Hill Cheese Shop, Bredenbeck's Bakery, Baker Street and Top of the Hill Deli, which have all donated food for donors. Bales said a lot of effort from CHCA staff members Noreen Spota and Celeste Hardester was crucial in planning the event.
The blood drive will be held at Vare Field House on the campus of Springside Chestnut Hill Academy, 8000 Cherokee Street, from 8 a.m. to 1 p.m.
The drive will be conducted by the Miller Keystone Blood Center, an organization that keeps donated blood in the local Philadelphia area.
Anyone who wants to give blood should call to make an appointment. Appointments will help Miller Keystone establish staffing levels for the drive. Anyone interested can make an appointment now by calling Noreen at 215-248-8810 or emailing her at email@example.com
In addition to blood donations, Bales said that donors could register for bone marrow donations, a simple test that adds potential donors to a list.
"Just getting on the registry is not a commitment," Bales said. "If it turns out you're a match you will be called to let you know. It's then that you can decide to commit or not. Marrow donation is not always scary, either. Sometimes it can be just like giving blood."
Bales said bone marrow donations helped prolong Garofalo's life for at least 18 months. It's because of how difficult it is to find a marrow match that willing donors join the database.
Bales said the most important thing for anyone who is on the fence is to find out more by consulting Miller Keystone's website, giveapint.org, to check your ability to give.
"People have lots of reasons for not giving," Bales said. "That's OK. I'll be there all day. I'll hold your hand."


text:
The Plainfield School District is working to add the "A.L.I.C.E" system to its list of initiatives designed to improve and maintain safety in its 30 schools.
The "A.L.I.C.E." system is the latest "best practices" security protocol. It essentially lets students and staff decide how to respond most effectively to an Active Shooter situation.
"History has shown there is no single response that fits all active shooter situations," Superintendent of Schools Dr. Lane Abrell wrote to all families in a letter issued on February 26, 2018.
Therefore, making sure everyone knows his or her options for an emergency response is important," Abrell wrote.
District 202 administrators have been working with the Plainfield Police Department for more than a year to add the "A.L.I.C.E." protocol to its lockdown procedures. Students and staff are being trained, one level at a time, starting this spring with high schools.
District 202 works very closely throughout the school year with the Joliet, Plainfield, Bolingbrook and Will County Sheriff's police departments that serve its 30 schools. Law enforcement conducts several unannounced intruder drills each year.
Administration meets each summer with officers to review its responses and get guidance on ways to improve security. Police first suggested the "A.L.I.C.E" technique during one of those summer review sessions.
A.L.I.C.E. stands for:
To date, all school staff have received information about the "A.L.I.C.E." technique. Seven administrators also went to a two-day certification training and the district will continue to provide more opportunities for staff certification training.
Likewise, all high school staff have received a second "A.L.I.C.E." presentation. All high school students will get the same information by the end of April 2018.
Finally, next year, all middle and elementary school students and staff will receive age-appropriate "A.L.I.C.E." presentations.
"We have worked hard, together with our law enforcement partners to create and maintain safe schools for all of our students, staff and families. 'A.L.I.C.E' is the latest part of that work," Abrell said.


text:
1. conceit - noun
· feelings of excessive pride
Synonym(s): amour_propre, self-love, vanity
Hypernym(s): pride, pridefulness
2. conceit - noun
· an elaborate poetic image or a far-fetched comparison of very dissimilar things
Hypernym(s): trope, figure_of_speech, figure, image
3. conceit - noun
· a witty or ingenious turn of phrase; "he could always come up with some inspired off-the-wall conceit"
Hypernym(s): turn_of_phrase, turn_of_expression
4. conceit - noun
· an artistic device or effect; "the architect's brilliant conceit was to build the house around the tree"
Hypernym(s): device
5. conceit - noun
· the trait of being unduly vain and conceited; false pride
Synonym(s): conceitedness, vanity
Hypernym(s): trait
Antonym(s): humility
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text:
Borderlands 2 PhysX Performance and PhysX Comparison - GTX 680 and HD 7970
PhysX Settings Comparison
Borderlands 2 is a hell of a game; we actually ran a 4+ hour live event on launch day to celebrate its release and played it after our podcast that week as well. When big PC releases occur we usually like to take a look at performance of the game on a few graphics cards as well to see how NVIDIA and AMD cards stack up. Interestingly, for this title, PhysX technology was brought up again and NVIDIA was widely pushing it as a great example of implementation of the GPU-accelerated physics engine.
What you may find unique in Borderlands 2 is that the game actually allows you to enabled PhysX features at Low, Medium and High settings, with either NVIDIA or AMD Radeon graphics cards installed in your system. In past titles, like Batman: Arkham City and Mafia II, PhysX was only able to be enabled (or at least at higher settings) if you had an NVIDIA card. Many gamers that used AMD cards saw this as a slight and we tended to agree. But since we could enable it with a Radeon card installed, we were curious to see what the results would be.
Of course, don't expect the PhysX effects to be able to utilize the Radeon GPU for acceleration...
Borderlands 2 PhysX Settings Comparison
The first thing we wanted to learn was just how much difference you would see by moving from Low (the lowest setting, there is no "off") to Medium and then to High. The effects were identical on both AMD and NVIDIA cards and we made a short video here to demonstrate the changes in settings.
Continue reading our article that compares PhysX settings on AMD and NVIDIA GPUs!!
One thing you may not right away - we are using an upcoming benchmark scene that was developed by Gearbox and sent to us by NVIDIA. I know, I know, some of you are going to complain about using a benchmark provided by NVIDIA, but I understand that this will soon find its way into the main game via an upcoming patch so I feel comfortable utilizing it now. The automatic run through uses real-time game engine code, AI implementation and effects of gun fire, exploding barrels and more, just as we saw in our 4 hours and more of game time.
Another interesting note is that this early version of the benchmark has two additional scenes when PhysX is set to the High preset - a bug according to our contacts at NVIDIA. Annoying, but not that big of a deal since it occurred on both AMD and NVIDIA based configurations.
From the video above you can see that the difference in game play from having PhysX at Low and Medium is pretty substantial - there are particles that come up from the ground when you shoot it, fluids that come out of exploding barrels, etc. The changes in moving from Medium to High are quite a bit more subtle and include additional fluid interactions and more particles in general.
Initially, NVIDIA told us that the PhysX settings were utilizing the CPU when a non-NVIDIA graphics card was installed, but as we looked at our results (on the next page) that doesn't actually appear to be the case.
Testing Setup and Configuration
For our quick testing today we were just going to run one AMD card and one NVIDIA card. In this case we used the Radeon HD 7970 GHz Edition 3GB card and the NVIDIA GeForce GTX 680 2GB - the top single GPU options from each vendor. Driver versions were 12.8 and 306.23 respectively.
Using FRAPS we recorded 80 seconds (almost all) of the benchmark map to get our average, minimum and maximum frame rates as well as our frame rates over time. Because we expected PhysX to use some additional CPU horsepower on the AMD card than the NVIDIA card, we used the Windows Performance Monitor to record total CPU utilization during the benchmark as well.
We ran Borderlands 2 at 1920x1080, maximum image quality settings with only the PhysX configuration changing from Low, Medium and to High.
Video News
Does nvidia still support using an old graphics card (ie. a 9800GT) in a secondary slot as a PhysX accelerator? I wonder if that would help the AMD case?
you can do that. See this page for more details:
I guess nvidia never really "supports" this as a driver hack is required, but it would be interesting to see the benefit of the added GPU physics processing.
in the nvidia control panel you can tell it what card to use for physx.
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Yes, if your motherboard got two PCI Express x 16 slots then you can use the second card dedicated for PhysX.
Yet again, if you already got a very powerful NVIDIA card (above 300 CUDA cores), then we dont need a dedicated PhysX card. Because for PhysX a card with 16 CUDA cores is needed.
I'm playing Borderlands 2 on a HD6970 at 2560x1600 with everything maxed. I have a GT440 I use just for physx (on high) and in some limited testing I've not seen the nvidia card go over 50% usage even during a big fight. Should be able to get by fine on a GT430 which you can regularly get for $20 on sale
Seems about right, half a GT 440 worth of computation. There is no reason a modern i7 can't handle that if properly threaded. It's cliche to say this by now, but Nvidia is playing really really dirty. I understand not spending resources getting their tech optimized for their competition's GPUs, but they purposefully crippled it on CPUs.
Shame on you Nvidia, and this is coming from the guy with triple 680s.
The problem is going from a highly parrellel environment to a highly sequential environment. The may be able to fudge it with low PhysX settings, but on high I'm sure it's trying to do the same thing a GPU does on the CPU because you have to use the same PhysX algorithms for reliability. So you end up with the CPU waiting on atomic functions and thread joins,. It really is likely just a consequence of how PhysX is implimented for the GPU structure, and is a non-trivial problem going between parrallel and sequential(with or without threading) efficiently.
Think about it. If you're processing 512 objects, that you can do in one instruction of the GPU after which the next function that requires those 512 to be done can be performed. While on an 8 core CPU you have to first, split up your threads (takes time),shuffle the data in/out of the CPU cache, while the GPU was able to transfer the same the data in one move, then when everything is done, you have to wait for every last thread to complete before starting the next function, so your waiting on your threads to join. Moving data around (especially randomly) is one of the more time consuming tasks for a CPU and so it isn't surprising that the processor may spend alot of time idle.
I just want to be clear, I'm not saying Nvidia could not do a PhysX-ish equivalent that's efficient on the CPU and would perform pretty much the same (that may be what PhysX light is for all I know). They could get something that is 'pretty much' PhysX equivalent. But the real PhysX engine fits the very specific criteria of modern GPUs. Processing the same instructions on multiple data in parrellel is simply what GPUs are made for and designed for, and CPUs will never be able to achieve this because they are not specialized that way nor do you want them to be.
And to expand on that point, NVIDIA has no reason to put any engineering resources into making something work better when you use a competitor's product.
I'm certainly not in favor of PhysX, but it is what it is. The CPU path isn't going to change.
Sorry but this is BS.You are saying that a faster AMD GPU can allow user to run the game with medium PhysX, while AMD GPU has absolutely nothing to do with PhysX. It all depends on CPU if you are playing with AMD GPU. However, even 16-core CPU won't be enough to cope with PhysX because Nvidia likes it this way.
Look at our CPU utilization graphs - it doesn't appear to be CPU bound.
the game is not using many cores, that's why CPU usage is low, but it doesn't mean that is not CPU bound, it is, but in a different way (more towards single core IPC), memory I/O throughput)
physx medium/high is pure CPU performance if you don't have a nvidia GPU, so if you have a 7770 or a 7970 it doesn't matter (at the worst moments, with reasonable graphic settings), the CPU is the defining factor of the super low framreates...
I'm surprised. I found it quite difficult to tell the physics difference between Medium and High in most cases except a few parts here and there that were noticeable. Ahhh how the gaming world brings us progress and new basic standards with each generation.
That's kind of my thought as well - I would be happy with Medium especially if there were any kind of performance hits that I noticed.
it`s probably because you don`t have a high end gtx to render the high set also about the cpu blabla overhere the i3 540 igpu has 1500 mb ram for rendering the hd res 1080p and my gtx480 handles 64 x mixed sample and 16 x aniso and ultra physx
there is a difference also philips pixel plus engine runs @ 170 hz and my i3 runs easy the 170-200 fps and the gtx480 runs ambient oclusion, aniso-mode 16x, 64x msaa,you need to bypass the framerate application control mode in nvinspector to highest available lot`s of features are turned of so that people with low end hardware don`t need to shut down features before they can play
I'm running GeForce v301.42 on a Gigabyte 560ti SOC (faulty pos fyi). Buttery smooth at 1600x900, everything on full except for filtering (set at x8). I'm playing as a siren if anyone is interested - might affect physx performance.
More than playable - I was stunned at how well this game runs. I know what it's like to play a slideshow (HL2 at 640x480 and 26fps max). I've noticed some textures appear as purple and particles appear blue once in a while. I've only crashed once in 4 days of my holiday Borderlandathon - a TDR resulting from my crap card.
So if i have a 7970 ghz edition and I got a geforce card for physx, how would that work? I know it can be done, but is it even worth it? Does the cost of the extra card make it worthwhile, and if so which card to get?
It was worth it for me, but I put 300 hours into borderlands 1 and will probably put more into this one. Just get a low end $20-$30 GT430/GT440. This video shows a comparison and has some setup info specific to borderlands:
basically install the 285 driver, install the standalone physx, run the extra hybridize tool. Rename/delete the physxcore.dll and physxdevice.dll files in the borderlands bin folder. You can use gpu-z to confirm physx is enabled on the ATI card and make sure it's put load on GPU2 during gameplay
every physX card runs the lowest for medium they are midrange cards and for high you need high end
make sure you put the gtx in the second pci express slot not the one close to the cpu there your biggest gpu should be when done download nvidia forceware you can run 2 different drivers no problem only make sure you set physX to the geforce
now you have all shader clusters for level of detail rendering let you play true ultra 3d textures you can use nvinspector to force ambient occlusion and when you think 120 fps on 1080p is good enough set MSAA 128x i don`t have a single framedrop , for the nvidia inspector users set AA behaviour flags to none! and AA mode to selector user instead of selector application then choose the forced AA 128x mixed sample already has super sampling so turn ssaa to none AA get done by the cuda clusters 16 for gtx580 fermi vs 8 for the kepler but kepler has better polymorph engine so they also can do 64x mixed sample 128x for sli
IMHO CPU PhysX is strictly single core crap (As I know it was year ago). This is reason why overall CPU load is so low. Give us utilization graphs per CPU core!
If possible, can you run the test using a lower to mid range card with physx on a single card, or physx running on a second low end card, eg a gt430 or lower + paired with a GTX 460 or a low to mid range AMD chip using the physx mod.
With games making more use of physx, it is worth checking if you could get better performance my adding a $30 videocard to a system with a mid range GPU (also post GPU usage of the low cost card dedicated to physx)
it may also be worth checking how much physx can be stressed before the limits of the low cost GPU is reached. (great if someone is thinking of getting a cheap GPU then keep that as a physx card for 3+ years while replacing their main GPU with more value oriented ones more often).
People always seem to forget that nvidia does a fine job using the CPU for software accelerated Physx on the Xbox360 and PS3. Neither of the GPUs in these consoles support hardware acceleration of Physx, so nvidia clearly has a smoother way to run it on CPUs only with their sdk. If they can do it on these console CPUs, then they can do a better job on PC cpus.
It could be a purposefully imposed threading limitation.
GPU's are heavily threaded and physx must be able to use more than one thread, or at the very least, not run physx on the same CPU core that the main game is using.
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so in the end i7 is and the fency amd cpu`arn`t the best in gaming also sli 680 or quad sli 680 ar not as good in handling textures as a i3 540 with gtx 480 dedicated to physX and AA and tesseleration cause that`s what a dedicated to physX card does also i get 170 to 200 fps on ultra with AA 64x also my gtx480 runs 99 procent for physX 3dmark score 5800 and furmark score over 8000 beating the 7970 incrosfire and also a i7 with gtx580 (msi lighting.btw i removed the reference cooler next day after i bought it.
also a lot of people talk about physics that`s a hole lot different than physX physX is nvidia only not amd it`s a big big difference between physics and physX i said it before and i say it again
tell your cat to stop walking across your keyboard. i cant read this shit.
Agree and well said xD
Running with GTX680 sli and see no performance gain at all . One card shows the same results as SLI !
Things I noticed in Combat GPU usage drops from 50% down to low 15-20-30% ?
Run two different video cards one from AMD one from Nvidia by installing the AMD in the first slot and resetting the CMOS
Source: http://fbappointments.com/consumer-products/computers/144-how-to-run-2-d...
I'm not sure that means what you think it means.
Fraps Benckmark @ 6080 x 1080 (Eyefinity Bezel compensation)
XfX Radeon HD7970 DD
Core i7 3820
RAM 16gb Hyperx
Mobo Intel DX79TO
Frames Time (ms) Min Max Avg
40444 1000247 22 101 40.434
All settings in high included Physx
Max Temp: 81*C
my system
Asus M5A99FX Pro R2
GSKILL 8GB (4GBx2) @1333MHz
Corsair 600w
i am running everything maxed out including CPU PhysX on High. about 80% of the time i do not notice any problems with performance of the game at all.
i do notice the giant performance hit from the "larger collections of PhysX simulations are running on the CPU." this is mainly apparent in areas like the Caustic Cavern when you fist get there. there is a pipe spewing out water and is spawns water until it can not spawn any more and then my FPS goes from 60-70 to a solid 20 with me just standing there. once i leave that room the FPS goes back up to 60+.
i also notice some times were there are small 1-2second slow downs.
ps. nvidia, when i have a little more cash i would like to get a PhysX GPU, BUT SOMEONE DISABLED THAT FUNCTIONALITY. i could get a 650 for $80 on newegg, or borrow the GTX 280 that i have in my other computer when i want to play this game.
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