Brenda,
Go to kellymom.com site and read about raynaud's. I know you feel it doesnt'
fit the typical presentation of this, but it definitely has some of the
characteristics, especially in light of the 5 yr history. Is it worse in
colder months? Also look under treatment. It does mention Ca/Mg I believe
and that has also been recommended for menstrual cycle symptoms, which you
did mention. Also dry heat I beleive is more helpful than moist, so has she
tried that and the wool breast pads? Also they recommend some meds to use.
I've also read a case study of chronic inflamed bilateral montgomery glands,
which you can find if you search some of those key words. It seemed a pretty
extreme case and extreme surgical procedure done to correct it, however.
Can this mom use gentle hand expression instead of a pump? Is she able to
hold baby skin to skin, if so she can express after a session. If using a
pump, have you tried a larger flange size to allow more room for her
nipple.?
The dry flaky areolar skin could indicate a pre-existing skin condition such
as eczema or psoriasis, so the referral to dermatology is a good idea.
Perhaps the "all purpose nipple ointment" many mothers have used and found
helpful would help her too. It contains an antiinflammatory, antifungal and
antibacterial component.
Laurie Wheeler RN MN IBCLC
MISSISSIPPI USA

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