My client has complained of sore nipples and spasms within the breast. Particularly when baby is nursing it is on the left side of the nipple. Baby has posterior tongue tie, with the highest palate I have ever seen and felt. Mom also mentions that the baby sucks really hard. Changed the position of the baby and pain decreased. I also gave mom a nipple shield because the pain was so severe and baby didn't pull off breast.  A week has gone by and mom mentioned that the baby breastfeeds with and without shield. The pain has decreased over all since last week but the deep itching within the breast has increased. No signs of thrush. Any thing else that I need to look at? Thank you all so much.  

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