Wondering if anyone would like to throw out some thoughts. I'm working with a second time nursing mom, who has been plagued with severe pain since the birth of her second baby about 4 weeks ago. Her significant medical history includes a diagnosis of congenital adrenal hyperplasia between her two pregnancies and subsequent daily oral steroids. She is clearly having visible vasospasms, and her nipples are "raw" is how she describes them, though they have no visible cracks or damage. We used APNO which seemed to help alleviate some of the rawness for about a week and then it returned. A nipple shield helped with her nipple pain for a while, though it seem to have lost its effectiveness. Her left breast was extremely tender to touch, with palpable areas of soreness especially covering the lower aspect of the breast. While she was being treated with APNO, she was put on antibiotics by her OB for her left breast tenderness, which did resolve, though the spasms never did. We have tried heat application, mildly helpful though the spasms return as soon as the heat is removed. We have tried Vitamin B6 per Newman's protocol which did help a bit,but her supply plunged after 3 days on high doses and even though we brought the dose down to 25mg she didn't recover her supply until we stopped the B6. I think it possible that she may have yeast, and we are waiting (and waiting and waiting) a callback from her OB to discuss Fluconazole and posibly Procardia for the vasospasms. My gut feeling though is that the problem is primarily vasospasm not yeast. What I am trying to tease through in my head is whether there is a connection between the CAH, the steroids, and the pain. Whether the condition or the meds could be predisposing her to the spasms. If I understand it correctly, steroids cause calcium to be lost from the bones - does this mean that there is then more circulating calcium in the bloodstream and could this be leading to her vasospasms???? Has anyone else worked with a mother on steroids who suffered from vasospasms (or CAH).Since we use calcium channel blockers to control vasospasms, I was wondering if there is a connection between high levels of circulating calcium and vasospasm and is there another way to deal with high blood levels of calcium if my theory is correct. Would a blood test for calcium show if her levels are high and how can they be safely brought down. For those of you in NYC who might suggest Mona Gabbay, she is on vacation til next week AAARRRGGGHHHH... Anyhow, if anyone can tell me if I am off base or has any other suggestions, I would be happy to hear them. BTW, I do not believe the baby has a posterior tongue tie for those of you who might want me to consider that one. Thanks for any ideas - Kathy Lilleskov RN IBCLC *********************************************** Archives: http://community.lsoft.com/archives/LACTNET.html To reach list owners: [log in to unmask] Mail all list management commands to: [log in to unmask] COMMANDS: 1. To temporarily stop your subscription write in the body of an email: set lactnet nomail 2. To start it again: set lactnet mail 3. To unsubscribe: unsubscribe lactnet 4. To get a comprehensive list of rules and directions: get lactnet welcome