Hi Fiona,
I do find that some moms are too sore and discouraged to work with the baby's
suck.  I make sure to remind the mother that bf shouldn't hurt, that of course
she doesn't want to do something that hurts her, but that we can help it not
to hurt.  I have had several moms quit several times and then go back to suck
rehab and nursing a day or two later.  When they call to tell me they are
quitting I am supportive and understanding, then remind them to pump so they
do not get engorged (keeps their options open, too), and encourage them to do
the suck work anyway to help the baby suck on the bottle better (many of my
babies do not do well on bottles either. I tend to get referrals from LLL and
other LC's who know that I am interested in suck; so I get the tough ones.).
Often the next day they feel better and start over again and succeed.
        The nice thing about stroking the tongue is that is often has an
immediate effect, the input increases the muscle tone and allows the baby to
suck better.  Once the sucking no longer hurts as much, many moms take heart.
        I have a much higher "quit" rate with moms of babies who refuse the
breast than with mothers with even deep cracks in their nipples.  What is
everyone else's experience with this?  I wonder if this is a more demanding
situation, or an area that I need more skill in.
Catherine Watson Genna, IBCLC