Hi Trish,
I'm mainly in the "there shouldn't be pain" camp, but there is commonly
pain during early breastfeeding because:

1. We mess up the initial learning period by taking babies away before
they have a chance to really learn to bf, and we drug them senseless.
(Righard and Alaide's work shows the affect of analgesics or even brief
seperation of mom and baby after birth on baby's ability to find the
breast, attach properly, and suck properly.)
2.  We prescribe scheduling feedings so that little colostrum drinker is
starving and hangs on for dear life in case someone takes the food away
again.
3. We grow up without watching other people latch babies onto the
breast, so we don't know how to position and latch them at first.

Now, in favor of the "it really does hurt in the beginning" viewpoint:

There is an inverse relationship between suck pressure and milk flow.
The lower the milk flow, the more pressure the baby is going to use.  So
I suspect if the milk is a little slow to become abundant, the baby will
use more negative pressure, and this might hurt mom's nipples.  Also the
flowing milk lubricates the nipples to reduce friction - no milk, no
relief from friction from the baby's tongue.

Interestingly, my homeborn second baby never caused me a second of pain.
  She was on the breast before she even had a chance to cry, just had
time to cough once!

When we have a breastfeeding friendly society, and we take care of
numbers 1 through 3, and we screen for and treat tongue ties, etc, then
we will get an idea whether there really is initial pain during
breastfeeding.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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