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 *********************************************** The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(TM) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html