Vasospasm is probably related to excessive compression of the nipple.  A
nice bulls-eye latch is not enough for babies who have small jaws or
tight tongues, the latch has to be asymmetrical and really perfect and
the tongue-tip positioned as far away from the base of the nipple as
possible to prevent the baby from just chewing or squashing the nipple.

What shape is the nipple when it comes out of this baby's mouth?  If it
is flattened, beveled or pinched, this is an indication that even though
the latch looks "fine" from the outside, it really is too shallow.

For right now, the mom can get some relief from the pain of vasospasm by
warming the nipple either with the palm of her hand or a warm washcloth.
  Dr. Jack Newman prescribes nifedipine, a vasodilator, one 30mg long
acting capsule/tablet a day.  Many of the moms in my practice have found
this made breastfeeding more tolerable, along with working on an
asymmetrical latch, time for the baby's short jaw to grow, treatment of
the tongue tie if that was the issue, and occassional alternative
feedings of expressed milk.

I'm glad you have someone wonderful to work on this baby's jaw.  And if
you refer to an IBCLC, you can ask to accompany the mom as a support
person.  I welcome doulas, grandmas, anyone who is helping the mom to
see what we are working on, so they can be more help to her.
--
Catherine Watson Genna, IBCLC  New York City  mailto:[log in to unmask]

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