I have a pt with a 3 wk old nursling. We had several latch issues initially which all have resolved; mom called today in tears, reports that she has a constant tingling feeling on one side when baby latches on and persisting for up to 30 minutes after a feeding. No dryness, flaking, rash, or sharp pains. No signs of thrush in babe's mouth. History of breast augmentation, under the muscle, nipple/areola not disturbed. She states her nipple, which is normally a dark color, turns very pale - almost whitish when nipple comes out of babe's mouth, so I'm thinking Raynaud's?  The color returns fairly quickly, she says. 
I found a great page in Marsha Walker's Breastfeeding Management for the Clinician (p 93) that says, " some mothers who have undergone surgical procedures on their breasts may c/o breast pain during lactatin. This may be due to the formation of scar tissue.....postsurgical mothers often experience nipple blanching or vasospasm of the nipple.....
I read this pg to mom and she discounted it, saying that her surgeon told her implicity that there was no damage to her nipple or areola. 
She says she's close to quitting because the pain is so bad.
I've recommended a consult to assess her latch, to see the nipple and areola for myself, as obviously I cannot tell over the phone. She declines to come in (bad weather, understandable) but I can't stand the thought of her waiting until Monday if she is that close to giving up. 
Thoughts? Suggestions?
Jennifer
Louisiana, USA

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