I saw a woman today who is two days postpartum and is experiencing extremely severe nipple pain. She reports that she has unusual sensitivity even when she was not pregnant. It is not related to vasospasm . Even relatively gentle expressing causes her pain and any amount of sucking, with a nipple shield,  causes exquisite pain. Breastfeeding without the shield is impossible. 

 Does anyone have any ideas what the cause could be and how to deal with it?

Thank you,
Riva Weissfish BA,CCE, IBCLC

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