Just had a fascintating followup with a woman who I have been working with 
for 3 months. She had been struggling with cracked nipples that wouldn't heal 
and extreme vasospasms as well, that were extremely painful and would last 
for extended periods of time. She is somebody who reports vasospasms in her 
fingers due to cold weather, so she clearly has a tendency toward this.We 
used APNO to heal up the cracks, which worked reasonably well though she 
still had mild cracks that would bleed intermittently. At seven weeks 
postpartum, she started on Nifedipine for the vasospasms, which worked 
beautifully to stop the pain of the vasospasms and simultaneously her nipples 
finally healed all the way. I am wondering whether the improved circulation to 
her nipples allowed that healing to take place and whether anyone else has 
had a similar experience. I had always heard that the damage seems to 
precipitate the vasopsams, but now I am begining to wonder whether there 
are instances where the reverse is true, ie poor circulation to the nipples is a 
contributing factor to the damage or its inability to heal.

Kathy Lilleskov RN IBCLC

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