I have received permission from my client to post this information and request advice. My client has 3 children. The first pregnancy resulted in twins and she pumped for 7 months. She said breastfeeding was too painful and difficult, but even pumping caused breast/nipple pain-though she persisted because of the benefits. She did not seek help with her first babies. Now she has a 4 month old and when I first saw her a couple of months ago she reported nipple pain. Observation at that time revealed nipple compression and with better positioning, deeper latch that improved. However, she recently contacted me again and said that even though the compression is gone, she still has severe pain in her nipples and breast when nursing, primarily during MER. I saw her again and observed her baby feeding-deep latch, no compression. Nipple and breast look healthy, no s/sx of yeast, infection, plugged ducts, etc.. She described the pain as most severe in the very center of her nipple and thinking she may have a plug, I asked her to express milk and noticed that she seems to only have ducts exiting in the very center (maybe 20% of the total area), nowhere else. It occurred to me that perhaps she has a very forceful MER AND very little exit room which combines for excruiating pain (Increase flow pressure with smaller diameter) We discussed this possibility and she said that it does feel like there's a lot of pressure with MER and until it stops, she has severe pain. Because she pumped so much with her first babies, she lets down just as forcefully with the pump, so it's no better. She really wants to continue nursing for a year, but is very uncomfortable. Does anyone have experience with this and are there any suggestions for relieving it? Tricia Soliz, RN, MSN, IBCLC *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html