The implementation of the HOT program at the Royal Women's Hospital

At the Royal Women's Hospital from November 1995, mothers and their infants were discharged on day three (a three-night stay) following a normal vaginal birth, if they were considered to be well and coping with early postnatal life. However, by March 1996, there were indications that not all mothers were managing breastfeeding as well as they needed to after discharge home. In an effort to reduce early avoidable breastfeeding problems, an extensive re-education program was undertaken. The 'Hands-Off Technique' Program (HOT) aimed to address the problem by educating the midwifery staff on ways to teach mothers about correct positioning and self-attachment of their babies without actually doing it for them.