I feel as if I'm speaking in an area for which I have little
authourity, only personal experience.  So bear with me and no flames
please.  Treat this as a case report.

I am still nursing my 28 month old daughter and all is well ;>.  But
when she was between 8 and 10 months old I started having extreeeemly
painful nipples during and between nursing sessions.  My nipples were
also sensitive to any coolness and blanched till they were white.  The
only thing that helped was warm compresses and tylenol.  My daughter
had had thrush about two months before and we both received treatment.
The "whiteness" was attributed to thrush with unsuccessful repeated
treatment.  I was about to quit nursing and since I had nursed my
oldest til 4.5 years, this was a big deal.

Coincidentally, I was having foot and ankle spasm-type pain.  My
physician told me to wear Birkenstocks and take more calcium.  My
daughter is dairy allergic so that my source of calcium was a Tums,
3-4 per day.  Increasing the calcium only seemed to make everything
worse. I did not make the connection between my feet and my nipples.
I was just generally misrable.

I am a PALS instructor and happened to be teaching a course where a
lovely physcian was a participant.  I offered to get her coffee when
she complained that she was cold in my room.  She declined and later
commented that I also should not be drinking caffeine, especially
still nursing.  I sheepishly went on to discuss "caffeine ok in small
quatities..."  Turns out her background is holistic medicine and she
beleives strongly in examining the biochemical interaction and effects
on our tissues of all we ingest.  She thought that the caffeine and
the carbonation in my diet were acting as diuretics, pulling calcium
out.  Because calcium and magnesium are competitive for binding sites,
the more hypomagnesic I became.  She thought my foot pain was
hypomagnesic tetany and that my nipple pain pain was a combination of
vascular spasm and ductal tetany.  Bear in mind, this was an over
lunch discussion, no labs were drawn, I don't even remember her name.

Long story short, I began taking a balanced calcium/magnesium (some
preparations also add zinc and/or betain) and my problems were gone
within one week.  At first I was sure it was placebo effect.  However,
I have since tested myself back on plain calcium and end up with the
same symptoms.  By the way, I still have 1-2 expressos per day and
still drink bottled carbonated water, still wear Birkenstocks, and the
physician-angel of mercy passed PALS.

The only reference I have found to this in the literature (and I have
not done an exhastive search) was a letter to the editor in I think
the August 1994 JHL linking low magnesium levels to nipple pain.
Perhaps these moms with nipple pain could benefit from an electrolyte
panel, or probabalistically, just supplement with magnesium for a bit.
It sounds far fetched, but it was a God-send for me.

Best regards,
------------------
Glenda Deahl, RN,C, ICCE
also still _patiently_ waiting for results ;>