There has been discussion of this in the past on lactnet -- probably during the winter. In the cases I have seen the infant was clamping on the breast at some point during the feeding. I was called in late in the game after several weeks, as the mothers were determined to brfd and experienced. The clamping had restricted the blood flow to the nipples. The mother experienced a VERY painful vasospasm. It was clearly not thrush. The pain was quite different in description. The nipples very white then very red. The pain was sharp but not hot. One mother weaned almost immediately (I was the lost hope -- fix it in one visit or else-- sigh) In the other situation unfortunately the reflex was well established and initially the mother would have pain even after pumping. This eased quickly but even after weaning and feeding ebm for several days, as soon as the infant resumed feeding directly the problem returned. The pain was intense and although we were able to ease it somewhat the mother was too worn out and weaned. She was an extremely active hiker and found it impossible to reconcile expressing/pumping and hiking. Obviously I have shortened this case history tremendously. We tried heat, massage, pain relievers, muscle relaxants, positioning, more frequent feeding, desensitizing the infants oral reflex, etc, etc. We did not try some of the alternative oral chranial manipulations I hear about on lactnet. I sometimes wonder if they would have helped. This mother was a occupational therapist so was very inventive with alternatives. I also wonder what would have happened if we had started working on this earlier. The problem was dismissed as regular positioning for several weeks in both of these cases. You know -- just grin and bear it, this is normal for breastfeeding arghh. I know none of this helps in the current case but I didn't want you to think you were being ignored. Does anyone out there have anything that HAS worked effectively? "Without interest and passion, nothing great has ever happened in history" G.W. Hegel Rhoda Taylor, B.A., IBCLC 3346 Glacier St. Duncan, B.C. Canada ph. 604 748 4945