Hi Amy,

That is a tough situation. I think some mothers have found relief by a few days of nipple rest and in the meantime and for a while, using some NSAID like Naproxen around the clock. I think others have talked about using something that works for fibromyalgia like Lyrica, I think. Not sure if that has been studied or anecdotally written up as a case study? I have talked about doing a nipple skin culture and clean catch mid-stream milk culture to see if there is an infection present. I wonder if mom’s have some degree of vasospasm and would warmth and/or a trial of nifedipine work? Some moms apply ice prior to feeding. 

Occasionally mothers use antibiotic ointment on their injured nipples but I remind them not to use the kind with pain reliever in it, due to baby  concerns. See this link re oral ingestion. I know you said mother could wash it off, so maybe that is safe?
http://www.usatoday.com/story/news/nation/2014/07/03/lidocaine-teething-children-babies-fda/11798367/

What is interesting to me is this: did these mothers have any nipple trauma in the early days, or were their nipples always intact but just sensitive. I think early trauma and pain may sort of ingrain the pain pathway???
Laurie Wheeler RN MN IBCLC
Mississippi Gulf Coast USA 



             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome