Hi Pat
Maybe try to decrease the supply and thus the forcefulness of MER too.
Barbara W-C said: "I also have a similar cohort of women with deep breast
pain and
chronically sore nipples who have too MUCH milk.  Their infants may also be
driven to distort the shape of the nipple, pinching off the excessive flow.
They may also suffer from chronic low-grade inflamation of the breast due to
residual milk sitting there that the baby can never fully drain off."
and this makes a lot of sense. Maybe treat your client with supply
regulating measures, pain med or ibuprofen, and APNO cream and pain may
subside when everything equalizes.

Laurie Wheeler, RN, MN, IBCLC
Violet Louisiana, s.e. USA

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