Hello,  I am what I will call a "lay breastfeeding counselor".  I live
in an area where there is only one hospital with women's care
servicing a somewhat remote but large population.  This hospital does
NOT encourage or support breastfeeding.  Consequently I am very often
trying to offer the best support I can to many breastfeeding women I
come into contact with (nearly all of whom have been encouraged to
stop). As I technically fumble my way along, I do have the resource of
my mother, whom I often call for advice, as she is an LC in another
state.  She also subscribes to Lactnet but as of yet does not have the
capability to post.

I have seen the recent posts discussing severe nipple pain and I have
my own case to relay.  I am sorry that this is so long, I don't want
to leave out any info that may help in coming up with a solution.  I
have had and breastfed two children and am expecting my third in
April.  Both labors were without intervention, pain relief, medication
of any kind.  Both babies BF immediately, often, and seemed to have no
problem.  In both cases, within a few days I was experiencing
excruciating nipple pain.  This pain I would categorize as far worse
than the pain I endured in labor.  With the first, I took T-3s on the
second day, saw a noticeable drop in the babies wake time, became
scared of drugging her and stopped the T-3s after about two or three
days.  Then I just endured.

  The second time the nipple pain was even worse.  (At one point I
  even considered stopping, which is an
absolute unspeakable thing for me.  Before this I NEVER EVER would
even remotely consider such a thing).  I took Advil (600mg) every 8
hours, and Tylenol(600mg) every other 8 hours for the first 2-3 weeks.
 The pain at latch on was so severe that I actually had to sit against
the wall and bang my head as my son latched on.  After a few minutes I
could relax and bear it.  Both times my nipples cracked and scabbed
and bled, over and over but did not seem to be particularly dry.  Both
times I would, after each feeding, hand express a little colostrum or
breastmilk, rub it into the nipple like a creme and let them air dry.
I wore 100% cotton bras and shirts.  The second time only I also used
a "Lanolin Hydrous" topical lubricant which I would glob onto to
nipple after a feeding and just let it wear off until the next time.
The coolness of it seemed to offer some pain relief although it did
not seem to stop the overall damage/probelm.

Both times my mother (the LC) visited and was able to watch latch on,
position, asses sucks, etc.  She was unable to find any reason I
should have such pain.  She said my case stumped her!  (and encourages
me to post this now)

It seemed to me that whatever was causing the pain never did stop, my
nipples just became so tough that they could stand anything.

I have relatively fair skin, burn easily, and have what I think are
relatively sensitive nipples.  I have not had any cases of dermatitis,
excema or other skin disorders that I am aware of.  I have always
avoided soaps and shampoos, etc. on my nipples though likely a little
contact will happen in the shower.

There were 5 years between my first child (who weaned herself at about
18mo-2years) and my son who is now 15 months and has  just this last
week, weaned himself (its a hard thing to have such a little one
refuse!  But as I am now 7 months pregnant I assume it is due to milk
changes)

In two or less months I will have another baby.  I am not apprehensive
about labor and delivery.  I am, however, petrified to breastfeed!  I
am asking, nay, begging and pleading, for ANY suggestions, ideas, help
that anyone has to offer.  I hope to in advance be armed with some
help this time.

Of the breastfeeding mothers I have been encouraging, none currently
experience similar problems, But I have encountered enough of those
who have that I began to think it was to be expected with early
breastfeeding.  We could all use your help!

TIA
Mary Wichman