Hi! I am working with a mom who has been c/o breast pain, past yeast
infections,recurrent plugged duct and mastitis. Her child is now 14 months
old. Her first plug came when he was one month old. She said she never
could keep it clear. I have not worked with her in person before now,
because she lives 275 miles elsewhere (her family lives here)
She states that she has felt confused and concerned about the advice she
has been given recently. She recently finished a 6 week course of
Zithromax. Her provider is a Physician and IBCLC I believe has recommended
the continued use of antibiotics throughout her lactation or weaning on
that side, that it is the only way to deal with her problem. ( all this
action is in her upper right breast quadrant). She is still c/o pain, lumps
and a ropy feel. To add to her stress her aunt told her "It could be
cancer". She set up to see me,for when she arrived. I then recieved a phone
message that "It seems like alot of the swelling has cleared, but my breast
still hurts and I have a pea sized lump" I told her that I would be happy
to talk to her doctor here, and see if he would agree to an ultasound,
given the length of time, pain, fear and confusion she seemed to be
experiencing. She thought that was a good idea, but would still like to see
me first just to see what I thought.
I examined her breasts and noticed asymmetry; her R was quite a bit smaller
than the L, I then palpated her breasts but could not feel any lumps even
when she guided my fingers. They felt a bit fibrous or ropy, but not
dramatically so. I asked her if her R side was always smaller than her L
and she said no, but that he didn't seem to like it as much and when she
night weaned at 10 months, she noticed a change and it was also at that
time that she had a mastitis.
Heres the thing: She does not want to quit nursing that side and she does
not want to continue the antibiotics as she has developed diarrhea and is
concerned about yeast. Her hometown doctor here told her he doesn't agree
with her BFing doctor and thinks she should try Ibuprofen BID. I do believe
some of her pain is from inflammation given her history, but feel alittle
concerned about making or breaking recommendations. PS the ultrasound was
normal with lots of normal ducts. She places a lot of trust in me (deserved
or not) so.. I would like your help, cause I'm stumped. I did tell her to
pay attention to when her breast hurt what was going on and how severe ie;
scale of 1-5 and maybe look at it, was it blanched etc.
Forgive the length of this post. Humbly, Chris Clark IBCLC
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