Jeanette, I'm not even going to venture into the thickets of the primary
causes of this mother's nipple pain -- she has my great sympathy! -- but I
did want to offer some comment about the Reynaud's aspect, about which I do
have (unpleasantly personal-experienced-based) knowledge.
First, that I have never seen blue nipples, though mine blanched to white and
hurt like very hell. The first wave of pain immediately **precedes** the
white appearance and continues through it, but the real son-of-a-gun pain is
in the second wave, when the blood rushes back in. So as an LC you could
examine nipples and see them looking perfectly pink and ordinary, and yet
hear her describe Reynaud's pain at that very moment -- that would be
predictable.
Second, although I think I was more susceptible to Reynaud's blanching when
cold air hit the nipples, other abrupt stimulus could bring it on too, and
you bet your bippy this might include sudden heat (think: 98.6) or any kind
of bad latch pressure -- my third daughter was in in-utero tongue sucker and
is prone to pinch the nipple when she is sleepy, and did so much more in her
early days, and for a long while I would first feel the painful pinch and
then feel the blanch start.
And third, Reynaud's is usually secondary to something else. With two of my
children I had it start after battles with yeast, and with one of them it
recurred for a while while that tongue-pinch thing got worked out. I think
that nifepidine breaks the cycle of the blanching occuring, but if the
underlying cause of nipple trouble -- which in this case sounds like it's
tongue-related -- isn't resolved, the nifepidine isn't necessarily going to
be a good final solution -- even though it might eventually be so, once the
underlying problem is (hopefully!) resolved.
Good luck to her -- it surely is a drag and I hope she can bull through it to
solve the other problems so that this piece will be easier to solve too.
Elisheva Urbas
NYC
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