<.... a mom with a 10 week old baby.  She is breastfeeding and has developed a deep
pain in her left breast after nursing. She says the pain radiates into and down her
back....She says she sometimes sees a white "pimple" at the end of the nipple.
...but do you think it is a vasospasm? >

Hi Karen,
This sounds like thrush infection in the breast to me. The white spot on the nipple
is sometimes thrush too - it is not like bit of skin that could be picked off, but
like the white spot is part of the nipple, if you know what I mean. I find Gentian
Violet is good for these white spots (or at least better than anything else). Oral
antifungals will help the breast pain. Has she or the baby had antibiotics
recently?

On the other hand, vasospasm is referring to changes on the nipple: she would
report the nipple going white, etc, and the pain is more localised to the nipple,
rather than this radiating breast pain.

Lisa Amir
GP / IBCLC in Melbourne,Australia
BTW a news-type article on Baby Friendly that I wrote for the Australian Family
Physician has just been published in the May edition (Vol 28, No 5: 341-342).
(Sorry this journal is not on the 'net). I'm breathing a sigh of relief that the
Wyeth ad for S-26 Gold didn't end up next to my article. BUT it does appear at the
end of the article my friend, Jane Gunn, has written on the six week postnatal
check up.