I have always included a brief "how we got where we are" in my BF classes, where I touch on the fact that we've lost much of our woman-to-woman learning over the last several generations, including much about childbirth, parenting, and BF.  That if we had our mothers, sisters, aunts, etc., breastfeeding unabashedly in front of us as children, we would intuitively learn much about how to hold and latch a baby at breast, as well as about which techniques seemed to work best.  I tell them that 3/4 or more of the research we have on lactation has been done in the last 10-15 years, and that as a result there is much well-meant but inaccurate help out there, and that an IBCLC is probably their best source for true expertise. 
I mention that many women have latch pain at first, and that some mothers have hormonal pain that persists beyond latch even if the latch is good, for a day or two.  I try to emphasize that nursing frequently (moving milk effectively) in the first week will prevent much unnecessary pain (and that moms should be lying around snuggled with their baby, recovering, NOT in the mall).  But mostly I emphasize that nursing your baby is not something God or mother nature would intend to have hurt the mother (no logic there, for sure!), and that if it's not going well, regardless of how many people tell you it's going to be just fine, it looks good, etc., etc,, GET HELP.  GET MORE HELP IF THAT DOESN'T WORK, but to try to promise herself and her baby that she'll breastfeed come H. or High Water, for 3 weeks, getting help as often as needed (and watching for the baby's signs of sufficient intake along the way).  By 3 weeks, most moms are smoothing out; she's past engorgement, has a decent supply building, is past the first growth spurt, has begun to learn her baby's language, and if it's not gone well, by now she's decided either to get effective help (us) or buy formula.  I've had cracked and bleeding nipples, I know the reality there, and I know their pain is real.  I just think that articles like the one on the IHS site don't elaborate as to how many of those mothers had access to good instruction or help, vs. how many were left in the dark by our crazy institutionalized lack of support?  It leaves the impression that this frequency of pain and distress is TYPICAL!  I'm afraid of articles like this being the stats mentioned in parenting mags, etc., giving a very skewed picture of what breastfeeding is like for the world's women without our society's baggage or who have ingrained cultural support.  Few women in our culture experence "normal" births or lactation - too many practitioners leave their "teaching" hospitals NEVER HAVING SEEN NORMAL!!!!!  Give me biology and mother nature any day!  I owe my life and my three sons to high-tech medicine, so I have a very appreciative respect for medical care when needed.  But a normal, healthy woman having a normal healthy baby should not face a nearly 50% risk of being cut open or her baby pulled out, to have her child in her arms.  I think it was Maarsden Wagner who said "That's madness!"--
Kay McKee

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