If you do not see s/s of Reynaud's then your client might try:
CST for the baby (I think the long feeds could be a sign of
ineffective latch and suckle, even though latch looks good).
Anti-inflammatory by mouth for several days, like naproxen every 12
hrs, for mom.
RPS before every latch or pumping. Make sure to elicit good MER each time.
Has she tried "laid back" breastfeeding position?
I don't know if this is really the best idea: ice on nipples a few
seconds before latch or pump (if Reynaud's it is a very bad idea),
some desperate mothers do this and report it helps. Not sure if it
will affect MER.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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