Dear Lactnet Friends:

The Academy of Breastfeeding Medicine has a lovely algorithm for nipple
pain:
https://abm.memberclicks.net/assets/DOCUMENTS/PROTOCOLS/26-persistent-pain-protocol-english.pdf

I would also rule out spinal subluxation that could lead to compression of
the nerves innervating the nipple. What's her posture like?

Maybe a referral for a practitioner of breastfeeding medicine? Sometimes
breaking the pain cycle with an SSRI can be helpful.

Good luck. These are complex situations.

warmly,
-- 
Nikki Lee, she/her/hers
RN, BSN, Mother of 2, MS, Grandmother of 1, IBCLC, CCE, CIMI, ANLC, RYT500
*@NikkiLeeHealth*
www.nikkileehealth.com

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