Virginia posed a question about mothers with such exceedingly sensitive
nipples that neither nursing nor pumping are tolerable for her.  Diana described a
mother who was nearly hysterical with pain when the babycame near enough to
*begin* latching.

I have worked with two mothers who were addicted to street drugs until
pregnancy, and who were taking methadone when I saw them.  Both of these mothers
reacted like Diana described.  Although the first mother would not admit to me
that she was a drug user, the nurse who referred her to me told me of the
situation.  This nurse also told me that drug users are *frequently* very sensitive,
as though the drug use heightens all sensations and makes everything feel
much more painful.  I did not feel I could talk about how her drug use may be
affecting her perceptions with the mother, since she herself had not revealed it
to me.  With the second mother, her situation was "out in the open" and I
could discuss it more directly with her.  In both cases, I asked these mothers to
try allowing baby to come to breast, do childbirth breathing if it helped, and
wait to see what happened.  In both cases, the mother's sensation of pain
lessened dramatically after approximately 1-2 minutes.  I don't know if it would
work that way with all mothers in similar situations.
       The first mother tried breastfeeding a couple times more, but then
stopped.  However, in conversations with her sister, it was apparent that this
mother was not really ready for the responsibilities of motherhood, as she left
her baby with grandma one evening in the first or second week postpartum
"while I go see a movie", and did not return until morning with no explanation.  So
there were probably a lot more reasons than pain for this mother quitting
breastfeeding.
       The second mother, with whom I could freely talk about her situation,
could understand how the drug use was affecting her situation.  She also had a
*very* supportive husband.  She went on to breastfeed for several months.
       I'm not saying that drug use is the only reason a mother would
experience such severe pain.  But it could be helpful to keep this in mind as a
possible explanation, even if mother hasn't mentioned it, much like we keep
possible sexual abuse in the back of our minds.
       Dee

Dee Kassing, BS, MLS, IBCLC
Collinsville, Illinois, in central USA

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