I wonder if the problem in the shower is just at the beginning, when the water first hits her, or persists once she has the warm water running all over her.  With me, when I first got in the shower, my whole body would tense up, at first, but my breasts were the most painful thing (I have fibrolyalgia, which I think causes the overall problem).  I also wonder, as far as the part about the aerola, if it shrivels up real hard or something else.  That is what mine did.  It wasn't just the normal thing that happens when you get cold, though.  The size of them didn't decrease as much as like when I wasn't nursing and would get cold.  I got deep fissures in my areola, that looked somewhat like because it tensed up so hard.  Soon after, they would turn white, then blue, and the pain was severe.  It was never formally diagnosed as Raynaud's, but I think it was.  I researched it and that was the only thing I could find in the literature that sounded like it.

What helped, at least for me, was to try to keep the temperature as stable as possible and avoid ever having water evaporating off of my breasts, like getting out of a shower, rinsing them off, and especially when babies unlatched.  I took baths instead of showers, and made sure the room was warm and humid.  I would run the hot water, close the door, and wait 5 minutes or so to go in.  Then, I got into the tub gradually.

For when the babies unlatched, I had squares of cotton flannel that I would fold into four layers and use as nursing pads.  When I took them out to nurse, I would put them inside my clothing, so that they would stay warm.  When the baby unlatched, I would quickly replace them so that there was no evaporation.  

When I first started nursing, it would sometimes hurt a little bit, but the warmth of the baby's mouth, and probably the suction, seemed to stop the spasms.  When I was having a lot of trouble with it, pumps were really hard to use because just the steam from the milk would cause some evaporation.  I made some attempts to figure out a way to keep the air inside the pump horn and collection bottle warm.  Soaking them in hot water first helped a little bit, but they cooled off pretty quickly.  I didn't pump much, anyway, so it didn't make much different but if your client needs to pump, and has the problem when she is pumping, she might want to explore that possibility a little more.

I've shared this with quite a few other moms, over the years, who said it helped them, too.  I hope your client finds something that helps!  
 		 	   		  
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