A colleague of mine is working with a 36 y/o G5P4 mother with a full term newborn who reports chronic nipple pain/sensitivity throughout all of her lactation experiences. She breastfed two other children at breast for 6 months, and pumped for 12 months for a child w/ an anomoly who was unable to breastfeed at breast. 

Maternal nipples medium, dense at nipple tips with elastic base. Appear flat with initial observation, but become erect with rolling and shaping. 

No s/s of Raynaud's, no other prior medical history other than breast fibroids. Mother reports such sensitivity to nipples that she cannot have the water of a shower spray directly on her nipples throughout any of her lactation experiences. She said that she "dreads" the initial part of the breastfeeding, especially the initial latch. There is some improvement in the pain as she adjusts to the feeding. 

This infant is latching well with the asymmetric latch technique. 

Anyone have experience with chronic nipple pain and sensitivity in absence of any other medical conditions? And what do you recommend?

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