I agree with Jan's post stating that in her experience some women experience 
transient latch pain in the early days.  I think when some women hear that there 
should be "no pain" they take it to mean "no sensations".  Pain experience is to 
a degree "in the nerve endings of the beholder".  For some women, especially if 
they have not had, or have been uncomfortable with any "action" with their 
nipples, the gentle tugging of the baby is a new sensation and may be perceived 
as discomfort until they are accustomed to it.  Another factor is the fact that 
in our culture, we protect our nipples from the elements, sun, wind, rain, 
temperature change, and thus they may be extra sensitive, at least for some.

I try to avoid asking, "does it hurt?" and instead say something like, "how does 
nursing feel?".  Her reesponse, both verbal and facial/body language tells me 
how to proceed.  If she says, "not to bad" or "OK", but winces with latch, I 
need to assess further.  On the other hand, if she says it is a little 
uncomfortable and if she shows a startle-like reaction to latch, but quickly 
relaxes and smiles at baby, baby changes from quick sucks to deep draws, there 
is audible swallowing, the nipple comes out shaped normally, and baby gives 
signs of satisfaction, I feel it may be a normal initial response.  Another 
factor may be that the first few "dry" sucks until MER may be especially strong 
for some.  If further assessment reveals no cause for concern, i tell her the 
following (or something close to this).

"Baby seems do be doing an effective job with nursing.  Nursing a baby is a new 
sensation and for some it may feel strange, even a little uncomfortable at 
first.  This fades over the first days as you become more accustomed to this new 
sensation.  If you feel a slight discomfort when baby latches which guickly 
fades, especially as the milk flow increases, it may be perfectly normal. After 
a few days, you won't notice it.  On the other hand, if discomfort increases, 
nipples look a different shape when basby lets go, or baby is never satisfied, 
we may need to work as little on refining the latch, so please get back to me if 
it gets any worse or does not decrease over the next few days."

Winnie Mading, IBCLC (for now-not sure if I'll recertify since I am retired.  It 
would mean I also have to change my liscense plate and e-mail address!)

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