Others may disagree with me here, but I definitely tend towards the "no
pain" school. I agree that there are some women with what I would call
"hyper-sensitive" nipples, women who find it painful to have their nipples
touched during sexual foreplay, for example, and they may have some real
discomfort during breastfeeding. But I believe they are the exception, and
that for the vast majority of women it should not be painful.

I say this in part because I have had the great privilege of spending time
with Jack Newman in his clinics, and I've seen how he can make fairly small
adjustments in the baby's latch that make a huge difference. I think that in
most cases some "fine-tuning" of latch and positioning can significantly
reduce or eliminate pain.

When the mother has an initial few seconds of pain, followed by comfortable
feeding, I usually interpret that situation as meaning the latch is not
perfect at first and the baby "fixes it" as he sucks. I often find that I
can help these mothers by teaching them a more asymmetrical latch.

One situation I do sometimes see is that some bad early feelings have left
the mother's nipples or areola bruised by the baby's jaws clamping down. I
can have the mother press on that area with her fingers so that she sees
what level of pain she should expect - if it is more than that when baby
nurses, she needs to work on the latch.

We may not be able to eliminate all pain for all breastfeeding women, but I
think that usually we can.

Teresa Pitman
Guelph, Ontario

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