I became a Leader in 1983, graduated from nursing school in 1996, and was
determined to send our moms home from the hospital with no sore nipples. So
this is a favorite topic with me. After all, I "knew" there was no reason
for sore nipples if the latch was good. Heaven knows I'd done plenty of
latch workshops by then and I knew I was an expert. Well, I was -- but!!

Babies go to mom's arms immediately at our hospital, and don't usually leave
those arms until they've relaxed after their first nursing. Our nurses and
doulas are great at helping with a good latch, and not stressing if babe
doesn't seem interested. (Our babies seem to get headaches or just be
confused sometimes, just like everywhere else. But almost all of them get a
first good nursing to get off to a good start, and the others get
skin-to-skin until it clicks.)

And STILL - I have moms tell me they have sore nipples. I have learned to
ask what "sore" means....I think it was Sharon Humenick who did the studies
on three weeks of nipple tenderness that were printed in the Journal of
Perinatal Ed. Those moms did seem to say the nipple seemed tender and
stretched, when queried about their soreness. We usually say, "It's okay if
it's pull-y but not pinch-y". (Thank you Amy Majer!)  This seems to do a
good job of separating the two different kinds of soreness, and we work hard
with good asymmetric latch and good assessments with the pinch-y ones, and
of course we do the same with the pull-y ones. I would agree with Catherine
on those pull-y ones, it seems to get better as the babies get less ravenous
(if that's the right word!) and as the milk begins to flow.

Another good example of a study that would be very difficult to do -- guess
I need to go back and re-read Sharon's study and see if I can replicate it!

Dawn Kersula in Vermont

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