What's the baby's oral anatomy like?  I've observed that infants with
short mandibles and small tongues are most likely to cause pain during
and especially after breastfeeding for prolonged periods of time
(several months), because the generally use more compression on the
breast.  A very asymmetrical latch with head extension helps to align
the jaws better to increase baby's mechanical advantage during sucking.
   A PEFECT latch is necessary in this situation, good just won't do it.
   Also look for vasospasm, which generally occurs a few minutes after
baby releases the breast, and is intensely painful.  Warming the nipple
and nifedipine can both be helpful if vasospasm is happening.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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