Carolyn,
I hesitate to attribute nipple pain to purely psychological factors.  I
think that if everything "looks" right but it still hurts, then there is
still something subtle going on which we are not skilled enough in suck
assessment to pick up.  For example, some kids suck well during a "dry"
digital assessment, but use their tongues in interesting ways to protect
their airways when fluid is introduced....
        That said, there is an emotional component to pain *perception*.
Some mothers are more sensitive or more vigilant regarding pain than
others.  Hypersensitivity can also be caused by thrush or other
infectious processes.  Anxiety also heightens pain perception and lowers
pain tolerance.
        Let's be cautious here that we do not fall into the trap of
minimizing someone's pain because we are not yet skilled enough (as a
profession and as individuals) to identify the cause.  I can think of
unfortunate examples of this occuring in other health professions...
--
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]