Hi Charlotte,
I believe the best remedy for the majority of the cases of nipple
soreness is the same as the prevention:  optimal latch and
positioning.  This usually means asymmetrical latch.  It is amazing
how the pain relief can be instantaneous when the mother makes just a
couple of adjustments.  Nipples heal very quickly, even with
continued frequent nursing, as long as the optimal L & P are
maintained.

One of the most common adjustments I suggest is for the mother to
cradle her baby's neck & base of the skull in the web of skin between
her thumb and fingers (thumb by one ear, fingers by the other),
rather than using her palm to cup the back of her baby's head.  There
are so many "aha!" moments from that change alone.  (Many babies will
arch back against pressure on the back of the head, which is
counterproductive to getting a good latch.)

I say "arrgggghhhh" to myself every time a mother in pain says, "but
so-and-so said his latch looked perfect!"  If it hurts, it isn't
perfect.  And there is a lot you can't tell from looking at latch
from the outside!  I do most of my breastfeeding helping by phone, so
I don't actually see the latch.  I have learned what to ask and how
to describe what the mother should be looking for.  One of the best
diagnostic questions is "What does your nipple look like immediately
after your baby unlatches?"  If the mom says anything using the words
pinched, stripe, squished, flat, wedge --- I know the latch is not
optimal.

A mother who is dealing with persistent nipple soreness/tenderness
needs to keep  talking to breastfeeding helpers until she gets the
help she needs.  If the situation can't be fixed just by tweaking L &
P, a qualified helper can identify other possible causes and suggest
things to remedy them.

By the way, I haven't read the article by Albright that you cite, but
it may have misquoted the AAP recommendations.  Six months is the
recommendation for *exclusive* breastfeeding, not a minimum time for
any breastfeeding.  The AAP recommends breastfeeding for at least 12
months and thereafter as long as mutually desired.

Warmly,
Margaret
LLLL
Longmont, CO


>I am Charlotte, a student nurse at the University of North Dakota.  In our
>classes we are taught of the benefits of breastfeeding in both neonates
>and older infants.  The American Academy of Pediatrics recommends women
>breastfeed for six to twelve months (Albright, 2003).  However, I have
>known many women to quit after only a few weeks; most of the time it is
>because they have experienced nipple tenderness.  The most commonly


>References
>
>Albright, L.M. (2003).  Sore nipples in breastfeeding mothers:  Causes and
>      treatments.  International Journal of Pharmaceutical Compounding, 7
>      (6), 426-434.

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