Thank you, Jeannette, Thank you, Kerri, 

Saw this Mom this morning. I suspected Raynauds originally, but mom was having such a rough time, she didn't understand. With the shower causing so much pain, and today, after the baby unlatched (using a shield on one side, because she's so overwhelmed with the pain and the baby has no idea what to do with his tongue yet, and the shield was helping him hold it down)  I sat there and watched the blanching spread across the flat tip of her nipple. She was more coherent and said, yes, her fingers and toes get white and cold and get "hives" after coming in from the cold. It makes total sense. She;ll be using warmth on the nipples immediately after each feeding and gently allow it to cool to room temperature, so the capillaries and vessels don't overreact to the pressure. suction and temperature changes. I've seen this work before, so I hope it does for her. If not, she can talk to her MD about Nifidipene. 

She's dealing with so much, but she's such a trooper. She's really working hard and I'm her biggest cheerleader (next to her baby and her husband, of course) The upper lip flanging is SO much better now. The baby has it figured out. 

We're using finger/mouth exercises and mimicking exercises (as of now, he really tries to mimic sticking out his tongue when you do it, and he laughs and smiles, and opens his little mouth and coos.... and can't quite get control of his tongue yet.) I did a gentle very soft sell when I gave her a list of CSTs, but they may need to come to that solution when it makes more sense to them. 

She knows I'm on her side. We talked about "resting" the nipple (the right one is much worse) and that she would do that as a last chance. She did OK with the shield (but with the Raynaud's it is still blanching in response to ANY pressure, suction, heat cold etc.) 

Thank you to all who emailed me as well. I see a lot of TT and TLF but this is a complicated case. Mom knows she can text or call or email me and I'll get back to her asap.

Warmly,

Mary Jozwiak, IBCLC, RLC
Board Certified Lactation Consultant, Post Partum Doula
Birthwaysinc. 
Chicago, IL 

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