I thought that the mammary constriction video was fascinating not just for what it delineated about the specific syndrome but also in its discussion of the response of the sympathetic nervous system to pain and the cascade of possible responses to pain and anxiety. Whether or not she has mammary constriction syndrome it sounds like she is very afraid of nursing and that there may even be some damage to the tissue in her areola since the RPS is painful. It seems like it might be  a good idea for her to take a break from breastfeeding by pumping for a little while.

I am wondering whether she has tried a nipple shield. Perhaps once everything has a chance to heal up and for her to simmer down (and therefore let her sympathetic nervous system simmer down in its response to nursing!!!) she could try nursing with the protective barrier of a shield between her and the baby. I have found them to be quite effective in situations like this provided the baby can move milk through it and provided the baby is willing to go back to the breast. It can decrease the clamp that sets off the spasm and also causes the tissue damage. It is also a physical barrier between her and the scary baby which can reduce anxiety if they are not so afraid that the baby will bite them. Of course, unfortunately with some babies nipple shields inspire biting!!!

Perhaps it could be done in conjunction with some doorway stretches and a nice massage of her chest, back and neck by someone she loves while she is trying to return to nursing. Even if it is not MCS, a massage might help reduce the anxiety that could set off Raynauds. I have also found that for some women there is time of day (often early in the day) where the Raynauds is less fierce. Sometimes they can nurse early in the day and then take a break with pumping as the Raynaud's fires up...night time is often the worst. 
Kathy Lilleskov RN IBCLC

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