Breastfeeding with Comfort and Joy: A Photographic Guide for Mom and Those Who Help Her by Laura Keegan, R.N., F.N.P. (registered nurse, family nurse practitioner) provides a beautiful photographic essay of both the artistic and practical view of breastfeeding. Parts of the book are purely for inspiration featuring lovely imagery, poetry and philosophy on breastfeeding and celebrating moments with nursing infants and their mothers and other loved ones. What makes the book unique is the intersection of photographs of real nursing images and breastfeeding instruction. Upon hearing about this book from colleagues, Laura Keegan was kind enough to provide me with a copy for review.

The best feature of this book is the close-up imagery of the stages of a good latch, which is really the most important aspect of pain-free nursing and one which helps ensure proper removal of milk. Descriptions and hand-drawn illustrations of latch in books, and even education at in-person breastfeeding classes, are often insufficient because women need something "real" to compare to when a baby is actually at the breast. In this respect I find this book an indispensable tool. I would also be remiss if I did not mention the quality and number of photographs of strategies and details for nursing twins. In all honesty, the book may be even the most useful for mothers of multiples.

However, I do feel that this book is best used in conjunction with breastfeeding education outlets or consultation with a breastfeeding professional. Clearly, from the testimonials included in her book, Laura Keegan has a long history of helping grateful women to breastfeed and the great respect of her colleages. However, notably lacking from participation in her book is contribution from any International Board Certified Lactation Consultants (IBCLC), which is not one of Keegan's credentials.

While the IBCLC is certainly not a trump card over a lifetime of experience, I did find several discrepancies in the breastfeeding instruction, both in details and sometimes in core understandings from the practices of many IBCLCs and the training in such programs. The details of potential disagreements on such issues as feeding frequency, nipple shields, candida or other issues are deeper than the scope of this review, I would feel more comfortable for women to rely on this book primarily for the photographic and step by step support. I don't see this book as a sufficient replacement for local support to interpret some of the recommendations and clinical information offered, especially as regards their specific situation.

That said, I think Keegan has done an admirable job attempting to address some important issues that often are more skimmed over in many breastfeeding texts and classes (hospital visitors, nipple "confusion" and the primacy of the need for skin-to-skin contact for example). She also truly has tackled most of the core issues admirably. While I may disagree with the specifics of some of her recommendations, part of causes trouble sometimes for new mothers is the conflicting information available. 10 consultants may provide 10 slightly different recommendations, partly because they are colored by their own experiences in helping women and babies or even their own breastfeeding experiences.

In this respect, Keegan has done nothing "wrong" with the clinical information she has provided I simply believe that many women's specific needs may not be met without a more personal approach. While for some women her instruction is perfect, for others it may be overly-simplistic or occasionally counter-productive. There is no breastfeeding "bible" and nothing is a substitute for a live breastfeeding professional or a veteran breastfeeding friend showing a woman "the ropes" as part of the breastfeeding "sisterhood" women need to recreate for one another if breastfeeding is to truly become the norm as it should be. Along with this personal support, this book is an excellent companion and reminder for a new mom.

One other thing I will mention, is that while the photographic support is unmatched in my experience, the layout makes the text incredibly hard to digest. It is not uncommon to have a block of text in a not-easy-to-read sans serif font filling a solid column down the center of a page. Even understanding the instruction, I found it hard to follow. As a new, tired, bleary-eyed mom, I'm not sure I could get through it. I hope that this is something Keegan can address in future editions of this book. Personally, I'd like to see the text for the core sections done in smaller blocks, perhaps more closely paired with the excellent photographs to provide more of a captioned photographic how-to.

I think my strongest recommendation for this book would be that every breastfeeding professional should have this on their bookshelf as a resource for clients. I think it would be lovely if after some instruction and caveats for personal client needs or personal professional practices, it could go home with clients. However, at a high price point of $35 plus shipping, this may be more commonly a professional tool. I'm certainly glad to have it in my toolbox. It would also be an excellent resource for La Leche League leaders, breastfeeding boutiques or pump rental outlets, peer counselors or even experienced breastfeeding mothers who will appreciate it for its celebration of breastfeeding and have it on hand to share with friends in need.

Overall, my kudos to Laura Keegan for taking the time to apply her career of knowledge to create this resource. For more information on the book, or to purchase a copy, see the link to Keegan's website in related links at the end of this article. To my knowledge, this book is not currently available through Amazon or most other mainstream outlets.