Sounds like she has alot of "plugging" from the start. Burning-shooting pain is common along with decrease output and mastitis. I would try soaking each breast in a bowl of warm/ hot water for 3-5 min using gentle massage during and then immediately pump or nurse with breast massage. Dissolving plugs under the nipple surface will allow for better drainage. She needs to be vigilant in order to keep from plugging over and over in the same places so massage is important. Have her take Lecithin daily. I also agree issues with the babe need to be ruled out as well.
Maria Parlapiano RN IBCLC
Chatham, NJ
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