To add to all the thoughtful comments of Winnie and others, here are a couple of points of my own:

- When talking with mothers who feel frustrated at not getting BF right at the very start, I use the analogy of learning to walk.  I point out that, like breastfeeding, walking is normal for the majority of humans.  However, most babies need some practice before they can take off and take those first steps without holding on.  Some will need longer to learn and gain confidence than others.  The miracle of breastfeeding is that it can often be learnt so quickly, more so than with walking - but there are also mother/baby pairs where it takes longer.  (I used to use the riding-a-bike analogy, but riding a bike isn't a natural skill.)

- After taking the case history and doing some education, much of what I do on post-discharge consultations, where some sort of problem is the reason for the consult, revolves on asking the mother, "How does it feel?"  This enables me to have some idea of what is happening in the baby's mouth and to work with the mother in fine-tuning the latch and positioning.  Just as importantly, knowing that a key indication is "how it feels" can be empowering for the mother, because she is not dependent on someone else telling her but holds in her own hands - sorry, breast - the key to when to adjust the attachment.  Like many others I use a pain score of 0-10, where 0 is no pain and 10 is the worst pain the client can imagine.  I also use verbal descriptors, e.g. "pinching", "burning", "cat's tongue" (which local mothers seem to relate to better than "friction").  When the pain score os lower on a particular attempt at attachment, I ask the mother to think about what she did that was even slightly different.  Oftentimes, it is that she stopped bringing the baby to the breast too high for the nipple.  None of this is new, but it doesn't hurt to reiterate it now and then.
     Virginia
     in  hot, humid Brisbane - how I loathe summer

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