Helen,

In my experience, damage of the thinner, more delicate skin in this area
(base of nipple) usually comes from severe traction/tension, and is very,
very painful. And of course, once the skin is broken, bacterial or yeast
infection could possibly set in, etc.

In the early days, it is usually from mother breaking suction incorrectly
and I don't see it nearly as often now that our local hospitals are not
telling mothers they must religiously break suction at x # of minutes and
latch baby on other side.

The other time in early days is when mom is experiencing such awful pain
that in reflex, without thinking, she simultaneously pulls the baby away
from the breast while pressing a finger into the areola to actually pull
the nipple out as fast as possible, instead of holding the baby very
close and breaking suction first. This can tear the skin.

When the baby is older (old enough to be very curious about his
surroundings) I have seen it happen either when the very bright baby is
impatient for a MER, and actually realizes he can stimulate one with
vigorous nipple tugging, or when the partially fed baby deliberately
slips down a little on the nipple but holds on for dear life while he
cranes his neck to see what is going on elsewhere in the room.

With this info, observing a nursing from start to finish might show
exactly how and when the severe traction is happening.

You might also feel the baby's teeth with your fingertip. Someone once
wrote in about some teeth with slightly jagged edges, being either filed
by the dentist, or gently filed with a nail file by a confident,
adventurous parent.

Hope this helps.

Jean
**************
K. Jean Cotterman RNC, IBCLC
Dayton, Ohio USA

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