I agree wholeheartedly with what K. Jean Cotterman described.  I
believe the primary function of any negative pressure is to keep the
nipple and areola positioned effectively in the baby's mouth.  So
many times I find that the simplest "cure" for tender nursing when
everything else looks effective is increased lift to the breast.
When mom lifts the breast a little more, the baby doesn't need as
much negative pressure to keep the breast where it belongs.
Incidentally, when I know mom also has one or more toddlers at home
she will likely need that free hand to tend to them as she nurses
the newborn.  I usually suggest if she still needs to support the
breast for comfortable nursing, she may be able to roll up a
washcloth and tuck it well back under her breast to achieve the same
effect and free up the other hand.  Also helpful for moms with
carpal tunnel syndrome.
Winnie Mading IBCLC

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