I have a client who was having sore nipples even though baby's suck seemed
fine with digital exam and he was getting plenty of milk.  He would feed
with *no* pain to nipples one feeding and the next there would be
excruciating pain.  Often when I was there all was well. The nipples were
not misshapen after feeding and didn't look traumatized.

Of course I checked for Y----.

There was some over supply problem and mom put powdered sage into capsules
and took 1 capsule 3 times one day and the supply decreased to a better
level. But the pain continued.

I suggested that she get some body work for her back, either chiropractor
or DO.  She did get the work and has had no more nipple pain.  I got that
idea from a JHL some years ago in an article that, I think, was about
working with thrush.  I've got to dig it out.

Whenever there are sore nipples and the usual causes aren't there, I
recommend the body work.  It has resolved the pain on several occasions. A
skilled massage therapist can do the work too. The mother needs to remind
the practitioner that she needs a pillow or towel under her abdomen so that
her breasts are not pressed in the prone position.

There is a band of muscles across the back where the bra would be that are
directly connected to the breast, and tension there can cause sore nipples.
Anyone who knows the name of the muscles can tell us.  This has been a most
helpful consideration in dealing with sore nipples.

Patricia Gima, IBCLC
Milwaukee, Wisconsin, USA

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