The part that hit me the strongest in your post was "mom had mastitis for which she did not complete the antibiotics." In many cases, not finishing the course, or a course of antibx that is too short (I've seen antibx prescribed for only 2-4 days for full blown mastitis) the weaker bacterium are killed off, leaving the stronger ones to multiply. The mother only recovers "partly" and may be saddled with a Superinfection on top of the original issue. Asking the MD to retreat for at least 10-14 days may be helpful. 

I agree with treating the bleb, and perhaps asking the MD for a full course of antibx to make sure all bacteria that caused the original mastitis are rid of.

If there was nipple trauma, it could be residual nerve pain, which I have personally seen frequently with damaged nipples. In that case (if a redux of antibx doesn't seem to help and there are no overt sx of thrush, which you said is probably the case)  Warm compresses and letting her know (of course as we can't prescribe) "some mothers find an mild pain medication that reduces inflammation like ibuprofen helpful for things like this" may help her a great deal, along with time to allow the nerve pain to heal. Let her know that the nerve pain may take a few weeks to heal. 

I'm not personally comfortable prescribing herbs, supplements etc, as it is not part of our scope of practice, although letting a mother know the old "some mothers have found" for things we have researched based data to back them up may be helpful. 

Good luck. 

Warmly,

Mary Jozwiak, IBCLC 

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