I have seen this problem off and on in the last few years.   The moms I work
with have had the best results with warm compresses applied before (if needed)
and immediately after BFing.   I recommend the uncooked rice in a sock,
microwaved for 45 seconds or however long or short their microwave is and then hold
it FIRMLY against the breast until blood starts to flow again.   I had a
breast reduction this past summer and experienced some of this as the nerves
healed.   Heat helped me too, although I wasn't lactating!!   The other way for wet
warmth is the multiple washcloths in a crock pot close to the BFing spot in
case mom is alone.   Every case I have seen HAS resolved sometimes in days,
weeks or months, with or without the RX and I always recommend the B6.   And YES
it is REAL and very PAINFUL.   Sometimes I see nipples blanching and ask the
mom 'does that hurt?' and they say 'NO' go figure... Although I am always
relieved it is not a case of vasospasm.
Annie VerSteeg IBCLC

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