Allyson,

I would recommend against hydrogels and APNO- if mom is experiencing vasospasm, these might exacerbate the pain by virtue of increasing vasoconstriction from the cool/wet context.  I would recommend mom cover breasts immediately after feeds with something warm and dry - wool breast pads, a rice sock warmer, a dry washcloth fresh out of the dryer, maybe even a heating pad on low.  Also, as the weather gets colder, simple things like wearing a hat and dressing in layers may help.  If her pain is related to vasospasm, she will probalby note that her pain is reduced when she covers her breasts immediately with something warm and dry.

Good luck!

Casey Clubb, RN, IBCLC
West Linn, OR, USA

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