Laurie -
A few years ago, while visiting the island of St. Vincent in the Grenadines,
West Indies I was asked to speak to new moms at a post-natal clinic.  Since
these were new moms who were already breastfeeding, I asked the head nurse if
she would like me to speak about sore nipples and positioning.  She was very
puzzled and said she wanted me to talk about weaning.  There "weaning" is
considered to be when any food other than bm is introduced.  Although they
breastfeed for about a year, they introduce supplementary foods at about 3 mos
which causes a lot of diarrhea, etc.
Afterwards I asked the head nurse at the clinic if she saw a lot of sore
nipples and she said they RARELY saw anyone with sore nipples.  They also do
NOT teach positioning.  And I saw a lot of positioning there that we would
have "corrected" here.  Most moms use a scissors hold, and those babies were
just hanging off the breast, not lifted up to breast level.
I don't know why they can bf with little attention paid to positioning and not
get sore.  Years ago we used to say that fair-skinned women experienced more
nipple soreness, but that is no longer believed.  The bf rate on St Vincent is
very high - about 90% I think - so I assume there is a lot of experienced help
from women friends and relatives in the mother's own community.  Maybe the
clinic nurse just never hears about sore nipples.  I just don't know.
By the way, I was there for the ceremoney when the hospital on St Vincent
became the first Baby Friendly Hospital in the English speaking Caribbean.
However their birthing practices are pretty barbaric - moms flat on their back
with feet in stirrups, and first time moms are often strapped down!
Cynthia D. Payne
LLL of Berkshire County Massachusetts