I am curious how often you may encounter a situation such as
this one, and what you do about it:
(This an amalgam of various situations, not any specific
person or case.)

Woman has contact with IBCLC within 48 hours of birth.
Complains of nipples so sore that she cannot stand to have
baby nurse. Pumping is also unbearable. Hand-expression is
somewhat tolerable, as nipples don't need to be touched. Baby
is already receiving bottles of formula,(colostrom expressed
is neglible). No apparent nipple trauma. Mom does not want to
put baby to breast to work on latch.

First thought is abuse issues (for the woman). But is it
possible for a woman who has never had any physical,
emotional, or sexual abuse to have such exceedlingly
sensitive nipples? Is this a psychological issue, or some
sort of underlying medical issue, or a variation of the norm?

Can this woman, who proclaims a desire to breastfeed,
actually breastfeed if she is unwilling to put baby to the
breast?
If she does not admit to any history of abuse, is it
appropriate to refer her to a therapist, with hopes that it
may help her to breastfeed?
What's an LC to do?

I appreciate any thoughts!

~Virginia Bobro
IBCLC, CD (DONA)



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