To All, 
My passion for the last 20+ years has been sore nipples---cause, prevention, treatment.(Has been interesting at social occasions when asked," what do you do"? I study women's nipples.) The discussion of the "nipple stripe" is interesting. I agree with Jean. From my experience in helping mothers with sore nipples to attach so that they are comfortable, it seems that positioning so that the nipple is past the hard palate relieves pain. There isn't much space in the infant's oral cavity. Is there a little more space posteriorly, enough that the nipple is not compressed as much, doesn't get as much friction from the undulating tongue? Does Jean's action of relieving swelling in the areola allow the infant to draw the nipple into the mouth further? How does the asymmetrical latch work? Most of the time I just work with the mother until she has little or no pain with latch. I have a description of what looks like good latch, but it doens't always agree with others. A few years ago I was asked to be a part of a research study. There were five Lactation Clinicians from across the country---and we couldn't agree on what constituted good latch and positon. As I have said before, we still need an established criteria for "good latch" and "position" on the breast. Let's keep discussing. 

Carol L'Esperance, RN, MSN, IBCLC, Albuquerque, NM

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