It is impossible to have much of an opinion without actually seeing this nipple, and I feel like I say the same thing now every time I post...but it could be vasospasm causing her continued pain. I see a LOT of mothers with pain for weeks and weeks duration before they see me...fo all sorts of reasons. This mom had poor latch initially, then perhaps yeast overgrowth, and now perhaps purposeful pinching to control fast flow...all reasons for nipple pain +/- deep shooting pains after feeding. BUT---even if all of the above is fixed, the spasm can keep itself going. It appears (ie no research) that in a susceptible person if spasm continues, the tissue is hypoxic for a period of time during the spasm, causing more tissue damage, leading to continued spasm. SO you have to break the viscious cycle of spasm to get the pain to go away. HEAT is by far the most effective way to do this...a heating pad on the "Low" setting works best...applied immediately after nursing or pumping for at least 5 minutes causes the vessels to open wider, not clamp down. It is VERY important to do this after every single feeding for a few days in a row to allow the tissues to heal, and thus very important the mom understand why it is necessary to do this extra thing. Kathy Leeper, MD, IBCLC MilkWorks- Lincoln, NE The contents of this message may be privileged and confidential. Therefore, if this message has been received in error, please delete it without reading it. Your receipt of this message is not intended to waive any applicable privilege. Please do not disseminate this message without the permission of the author. *********************************************** To temporarily stop your subscription: set lactnet nomail To start it again: set lactnet mail (or digest) To unsubscribe: unsubscribe lactnet All commands go to [log in to unmask] The LACTNET mailing list is powered by L-Soft's renowned LISTSERV(R) list management software together with L-Soft's LSMTP(R) mailer for lightning fast mail delivery. For more information, go to: http://www.lsoft.com/LISTSERV-powered.html