Sharon,
This sort of cut I usually find with the "Lips rolled in" problem - baby may be
in great position, start nursing fine, then during the feeds roll in the lips.
If this is the case, mom needs a finger free to regularly roll out the lips -
sometimes with a tissue around her finger to get a better hold as the wet lips
don't roll out so easily.

Another cause can be the incorrect positioning of the tongue that I find
frequently with epidurals, tongue-tie or fast let-downs.

As for treatment - the lansinoh or Pure-lan help with the repairs only when the
cause has been removed. And in one case I found the only way the mom could
continue breastfeeding was using a nipple shield.  Usually the moms that I give
nipple shields to stop using them within the first week, but one mom who had the
sort of damage you described used it for over 6 months of nursing without milk
supply problems.

Jeanette Panchula, BSW, LLLL,RN, IBCLC
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