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Subject:
From:
Barbara Wilson-Clay <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Thu, 9 Sep 1999 09:13:07 -0500
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I have so enjoyed the sore nipple discussion, not the least because people
have reminded us that pioneers in our field like Mavis Gunther and Niles
Newton have asked these questions and come up with some great ideas/research
which we must not forget about.  And what a pleasure to see Carol
L'Esperance's work getting the exposure it deserves.  We also need to
remember to read Michael Woolridge's milestone articles (the Midwifery, 1986
Anatomy of Sore Nipples etc).

On the thread about overly sustained negative pressure and a relationship
with sore nipples (Gunther's idea) I often see a certain kind of lesion when
that is the cause of nipple pain.  Compression or pinch wounds (where the
prob. is that mom has baby latched so that baby's lower jaw is compressing
the shaft of the nipple) have a characteristic "stripe" shape across the
face of the nipple along the crease line.  In situations where the milk flow
is low or slow,  baby  must suck overly hard to try to get a flow.  This
sustained suction tends to create a kind of star-burst crack in the center
of the nipple.  I think I recall hearing Kittie Frantz describe this
observation years ago -- I certainly don't think it is an original
observation of mine -- but it has held true in my assessments over the
years.  Ironically, both intense engorgement with occluded flow, and very
soft breasts with little milk both prompt babies to try to suck overly
zealously trying to get results.

Barbara Wilson-Clay, BSEd, IBCLC
Austin Lactation Associates, Austin, Texas
http://www.jump.net/~bwc/lactnews.html

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