This sounds like a latch issue.  If baby cannot get a deep latch, check for tongue tie or other anatomical issues, oversupply and underweight.  Shooting pain is likely vasospasm from the damaged nipple.  Fix the latch (by addressing mouth, O/S or underwt), and it will heal the nipples, and the shooting pain will go away.  You can't really declare a latch good or bad by how it looks, it's how it FEELS.
Annie Brown. FNP, IBCLC
Greenwich CT

On Mar 10, 2010, at 10:47 AM, LACTNET automatic digest system wrote:

>  am a new IBCLC but I have been a lactation educator for 7 years and this situation is troubling me. I have a mother that is struggling with what looks to be a yeast infection of the breast. This patient left the hospital and was struggling with shallow latch but that was corrected. Infant is now 3 weeks old nipples were healed from the shallow latch issue. Now at 4 weeks she  came to my clinic and she reports shooting pain from her side towards nipple "inside" each times that she nurses. Nipples are sore, cracked, blistered, reddned and painful when infant first latches then the pain goes away. I had mom come to the clinic and she latched infant while in my presence. Latch is not shallow all though I did encouraged mother to hold infant closer to prevent tension on the nipple. Infant positioned in cross cradle this is mother position of choice after trying other positions. 
> I encourged the mother to call her physician for a suspected yeast infection. I thought that I was right on target but when she saw the PA she was told that it was a shallow latch issue. Now mind you the PA did not visualize the infant latched. I am not sure where to go from here. I did instruct the patient to call her regular physician and explain the situation. I also instructed her to educate herself regarding the situation and referred her to the laleche league website. Mother is a trooper and will nurse to matter what but I am worried that this situation will get worse and want to help her with this situation??????????????????????????????????????

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