Sue Huml, your comments are very good and I completely agree re: pain relief
for damaged nipples being appropriate.

I also agree with Kathy Dettwyler. I think we see so many cases of damaged
nipples in North America because birth is managed so poorly with medications,
epidurals, forceps, separation of mom & baby, suctioning, etc etc. It's a
wonder any of these kids can suck at all, much less properly. If we did to
athletes what we do to babies at birth, world records would be at 1920's
levels instead of where they are today.

One more time - the baby's suck is controlled by muscles which must have
intact innervation, sufficient caloric support, good blood supply and no
pharmacological or other insults to contract sequentially and smoothly. PLUS,
no Super-stimulus causing a reverse muscle contraction pattern (i.e., no
teats or suctioning) to protect the airway. Most early nipple damage is
caused by mechanical forces inappropriate to the nipple tissue, where the
forces are excessive, improperly placed and/or for extended time.

All birth medications (repeat - ALL) have been documented to affect the baby.
 All mechanical and chemical interventions used during birth affect the
central nervous system and one or more of the 6 cranial nerves that control
suck-swallow-breathe. If you mess with the baby, you get messed-up suck and
damaged nipples.  This is not new information, folks.

Linda Smith, same song, one more time
Dayton, OH private practice