Jeanette asks:
<would you add "if you count to 10 after the baby
latches on and it still hurts, please call"???  Or would you say "if the
pain is greater than ___" please call???>

What I usually say is something like "if it doesn't feel better after the
first few seconds of the feeding, or if it hurts so much that you find
yourself dreading feedings, call and we'll figure out how to make it
better".

Maybe this is heresy, but I am not a believer in the "if it hurts, you're
not doing it right" premise. Theoretically, maybe. Or if it hurts "a lot"
(whatever that means across the wide spectrum of women we see!), or
persistently, or in certain ways, there are definitely things we can do to
correct the situation. But my experience has been that there are always some
women whose nipples are more tender than others', not even taking into
account different tolerances and interpretations of "pain".

When we're talking about developing materials for widespread use (WIC,
Public Health nurses, any general distribution), and especially when it is
material you give out prenatally, I've found it best to keep it simple. I
want women to know when they should call for help, and I want them to know
*who* they should call to get that help, and I want them to know that nsg.
doesn't always go perfectly right from the start but that there are
resources available to help them make it work for them. I *don't* want to
make it sound complicated or overload them with "if this problem comes up,
try..."

Cathy Bargar, RN, IBCLC Ithaca NY (who had some of the nastiest,
bleeding-est, most painful nips you'd ever hope not to see, and no idea
whatsoever that anyone else had ever had such a problem or that there were
ways to correct it. Who wasn't totally surprised, though, because she has
some of the fairest, most sensitive, prone-to-overreaction skin ever put on
a person.)

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html