Hi Janet,
Has anyone looked for thrush?  The nipples are often pink or reddened, with a
shiny appearance to the nipple or areola.  In severe cases, excoriation(sp?)
occurs (this is why the affected area looks "peeled", it is).  Pain is usually
worse right after a nursing (as the pain of a vaginal yeast infection is worse
right after washing or intercourse.)  If the yeast invades the ducts, mom will
experience burning, stabbing (from nipple inward), "electric" pains, with MER
and between feedings.  Please forgive me if you have already screened for
this.
        Another possibility is a chronic dermatitis, for which short term
(7-10 days) steroid creams are often recommended.  Mom will want to use a low
dose and apply very sparingly after nursing 3 times a day.  Such short term
exposures have not caused pseudo-Cushings syndrome in breastfeeding infants.
One of my clients with post-thrush dermatitis did well with vitamin E (from a
broken capsule) applied to her nipples.  This was recommended by a family
practice doc I referred her to when she was unsatisfied with her own
physicians' dismissal of the problem.
Catherine Watson Genna, IBCLC  NYC  [log in to unmask]