Sounds like a difficult situation -- that's a long time for anyone to be in pain. If she is really contemplating stopping breastfeeding, could she experiment with just pumping for a few days.  Do the vasospasms stop?  Is it indeed something subtle that the baby is doing while feeding -- perhaps clamping against the fast flow? Or sliding away to a shallower attachment (so maybe laying back a bit to encourage the baby stay dug onto the wide mouthful).

I explain vasospasms to mothers as a nerve pathway firing -- and every time the nerve fires, it reinforces the pathway, and makes it easier to trigger.  So the vasospasm home care aims at heading off the reaction, so the body forgets about that particular route.  So she's applying the measures before the reaction has happened.  So we're trying to keep the blood-flow high all the time (you've tried nifedipine, but the home care can include calcium/magnesium and B6), and the  breasts toasty warm all the time (consider the Lanacare or similar large fine-wool breast pads, which mothers really like, or a soft flannel/fleece scarf wrapped around inside the bra).  In addition to the dry warmth and massage after the feedings, massage right behind the nipple --working the blood back up into the nipple -- as one might massage blood back into a numb fingertip.

Mothers can spend a lot of time hunched over, and a person will naturally hunch forward protectively if they are expecting pain.  So look up at the idea of "mammary constriction syndrome" as a cause of deep breast pain.  When talking home care for vasospasm, it can't hurt to include to proposed measures for this syndrome -- of lifting the breast and also massaging with the flat of the hand on the pectoral muscles and doing pectoral stretches in the doorway, to open up and relax the spasming chest muscles.  I had one mother's breast pain stop when she started working out again.

Dealing with chronic pain is a medical specialty of its own, so try to find resources in that area.  I do remember something about anti-depressants being helpful with recalcitrant pain.  Could this be something like a fibromyalgia?

Anyway, a few ideas.  

Margaret Wills, IBCLC Maryland, USA
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