I have been following the theories that nipple pain may have an emotional
basis with great interest.  Breastfeeding is promoted so strongly in
Zimbabwe that it is the very brave new mother who will say outright that she
does not want to breastfeed.  Consequently she may feel "forced" to initiate
breastfeeding in order to be seen to be a "good" mother.  She will often
say, within the first few minutes "I really want to breastfeed!" but then do
almost anything to prevent breastfeeding from taking place and/or list
reasons why she or the baby "cannot" breastfeed.  At the extreme end of the
scale is the new mother who appears to experience severe pain in the total
absence of any physical cause and I have to conclude that the cause must be
emotional.  I have worked with three women in recent months who draw back
and cry out in apparent agony and terror just before or just as the baby's
mouth brushes the nipple - the baby is not yet latched (and has never
latched before, so there is no question of trauma) and the latest one
(yesterday, still fresh in my mind!) reacted this way to a breast pump.
Concerned family (if present) are naturally shocked and sympathetic.
Formula (ABM?) is simply not available in the hospital for full-term healthy
babies.  Any ideas out there for ways to handle this very fraught kind of
situation?

Pamela, Zimbabwe