Jack Newman wrote:
> >No, and if you have seen Woolidge's diagrams or video on how a baby sucks,
> >you would see that negative pressure has nothing to do with it.
and  Marie Biancuzzo answered:
snip
> But he's not saying that negative pressure doesn't exist. He makes a
> good point of saying that if the infant is not positioned well, then
> ANY amount of suckling time will cause sore nipples.
snip
The question is really about the presence or absence of
> milk in the ducts.
snip
, but the basic tenet here is about the full ducts causing the baby to swallow,
> which relieves the continuous negative pressure that the infant
> exerts when the mother's milk ducts are relatively empty
snip

If a baby sucks a relatively ''empty'' breast, this might cause discomfort or
pain within the nipple/areolar area or deeper in the breast, the feeling some
moms describe as ''like the baby it pulling out the lining''. Fixed negative
pressure or suction on tissues can make bloodblisters or subcutane bleedings,
like lovers tend to do with ''love-marks'' in each others necks. It will not
make nipples sore in the way we mostly see it (that kind of damage is caused by
rubbing the skin), but it can make a bloodblister or subcurtane bleeding if
suction is only performed on the nipple. If the baby has more breast tissue in
the mouth, the pressure is devided towards more tissue, thus having far less
pressure per square mm.  Pressure (be it positve or negative) and rubbing have
completely different effects on the skin. Thus sore or broken nipples will be
caused by not taking the nipple firm into the mouth and having it moverd or
rubbed against the tongue or other inner parts of baby's mouth or perhaps by
suction on only the nipple instead of the big mouthfull that is intended to be
in baby's mouth.
So if baby is latched on well and if baby has a good technique, no matter how
long he sucks or places negative pressure in the mouth, the nipples will not be
harmed.

Now I get to think of it, the negative pressure is only meant to keep the breast
well-positioned in the baby's mouth, not to draw the milk out, right? But I can
imagine that a confused baby can loose knowledge of how to keep the breast in
the mouth and than tries to do it by sucking harder and that could damage the
nipple/areola.

Gonneke van Veldhuizen, IBCLC, living in Maaseik, Belgium
http://www.users.skynet.be/eurolac
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