I would suspect pumping is hurting because she needs larger flanges.  Often 
inverted nipples are wider than average.  Have her lubricate the flange 
where her areola rubs against it.

ALso, if there are open wounds around the "base" of the nipple, wearing 
shells can help them heal by secondary intention faster than closing them up 
in a breastpad.

Kathy Leeper, MD, IBCLC
Lincoln, NE 

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