Becky,
I agree with you that positioning is the first thing to look at when
there are sore nipples.  This is because incorrect positioning and
latch-on CAUSES incorrect sucking by either reducing the infant's
stability (which reduces the ability to use muscles) and/or
mispositioning the nipple in the baby's mouth, which totally changes the
dynamics of sucking.  The baby's mouth must be full of breast in order
for the tongue to have a stable base for motor activity. (STABILITY is
essential for FUNCTION).  If the tongue is not stable, the lips and jaw
will do more of the work, resulting in excessive nipple compression,
pain and nipple damage.  I cannot overstate the importance of
positioning and latch on.  Most (but not all) sucking problems are cured
by correcting the positioning and helping the baby latch more deeply.
Catherine Watson Genna, IBCLC  NYC  mailto:[log in to unmask]