I know that awareness of the asymmetrical latch has changed the way I guide
mothers now, esp. those who are already sore when I meet them.  I said
different things before but I think the latches were just as good because
the pain, if there was any, got relieved then too.

But lately I've been thinking how strange it is that I managed to breastfeed
for the first time 23 years ago after a long and difficult labor with
operative delivery, with no hands-on help because I didn't need it.  I had
copious production by 48 hours.

In the hospital we were told to use (used) tea bags on our nipples if we got
sore, for the tannic acid I think was the theory then.  But I had a big lump
of lanolin brought to me by my best friend, where she got it from I have no
idea, it looked like it had been manually collected from the sheep!  I think
the clump got passed along, only slightly diminished, to the next new mother
my friend knew; I used it for a couple of days while my skin was getting
used to being wet all the time since my baby was definitely the sucker that
was born in her particular minute!

My point is, I didn't have a clue what a good latch was supposed to look
like though I did know baby should be facing me.  If I had felt any pain
besides the discomfort when my milk came in, I would have felt there was
something very wrong.  As it was, my daughter and I just couldn't get enough
of breastfeeding.  We both loved it, from the first feed on.  In my
experience as a midwife this is exceptional; most mothers and babies take a
few days to figure it out and get enthusiastic about doing it.

I'm with those who say that pain requiring an intervention to relieve it, is
not something I expect to find in well-functioning normal breastfeeding.
Transient pain for less than 30 seconds immediately following latch, in the
first few days, is as far as I'll go and still call it normal.

I think it was Righard and Alade who found a preponderance of bad technique
in dyads where baby used a pacifier, even when technique was satisfactory at
time of discharge home post partum.  If this is causing any of the pain
which mothers in the study referred to were treating with hydrogel
dressings, then maybe we have a responsibility to let them know that.  Even
if the hydrogels are completely benign and actually helpful for some women,
I assume they aren't distributed for free.  Are these women aware that the
one unnecessary thing they have purchased (pacifier), increases the need for
another thing to buy (hydrogels)?

Also, since I live on another planet, maybe someone can explain what a
hydrogel dressing is.  I don't think I have ever seen one.  We have
something called Mother Mates, which I have never recommended because I know
so little about them - could this be a brand of them?

Rachel Myr
Kristiansand, Norway

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