Gonneke and Mary Ann,

I agree that latch-on technique can make all the difference in comfort
during breastfeeding, but my learning curve was different from yours.  I
really "got" the asymmetrical latch  when Jack Newman came to Chicago in
1998 (well before 2001-02).  Chloe Fisher has been teaching it for as long
as I can remember, but I understood it much more clearly from Jack.

In answer to your question, I don't know whether the Dodd and Chalmers
researchers taught asymmetrical latch to the study mothers, but I have
asked by e-mail and will let you know when I find out.

Like you, Gonneke, the idea that nipple pain is "normal" runs counter to
everything I have always believed.  When I was in private practice, I was
very effective at helping mothers overcome pain by adjusting their
technique.  But as I said in my original post, the research shows that
most mothers do have pain (which as you said, makes it "commonly
occurring").  When I worked on The Breastfeeding Answer Book, I checked
into the works of everyone I considered an "authority," and discovered a
wide range of "normal," from no pain at all, to pain or tenderness in the
first few minutes of a breastfeeding for the first week or two.

Certainly the first thing to do when a mother has nipple pain and trauma
is to teach her how to adjust her latch.  In most cases, with good
instruction, pain and trauma can be quickly overcome.  When there are
anatomical issues (tongue-tie, unusual palates, "fit" issues between
mother and baby) or infection, pain (and even trauma) may not be as easy
to fix.

There is definitely an ongoing debate about what is "normal" (which was my
main point) and I think debate is always healthy.

Nancy Mohrbacher, IBCLC
Lactation Education Specialist, Hollister, Inc.
Distributor of the Ameda ComfortGels



(breastfeeding utopia)  where moderate to severe pain (not just mild
pain!) was reported
in 49% of  mothers on day 3 and 36% pf mothers on day 7. These were all
mothers who  had lots of LC one-on-one follow-up.

Nancy, I respectfully have to disagree that  this proves that pain is
normal.
It may be often occurring. It just is not  logical to suppose that using a
normal bodily function is painfull for almost  half of the population
after 3
days of practice and still for more than a third  after a week.
Mild sensitivity or even some starting pain  in the first days might be
normal for a never used breast, like starting  exercise may lead to some
musclepain
in untill then unused muscles. But using  bodyparts for their normal
function
should not continue to be  painfull.



Anyway, I would assume the Dodd/Chalmers study was done about 2001-2002.
Is
that right? That was about the time we were learning about the
asymmetrical
latch. At least that was when I heard Dr Jack Newman lecturing on it at a
WALC conference. If the LCs in the study weren't up on using the
asymmetrical latch we did have lots of soreness. Now with the new latch
aren't you finding a lot less complaints of soreness?



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