I saw a new mom today with a difficult problem and she gave me permission to post.  She had a 34 week preterm baby and direct breastfeeding has been delayed.  She has worked with 4 different lactation consultants and has been able to get baby to breast, but says that the pain is untolerable.  Because of the difficulty and frustration with latching and the pain, she has mostly been pumping breastmilk.  Unfortunately this is also very painful, almost unbearable.  She has tried several pumps and several sized pump flanges, but everything is painful.

I watched her pump today.  She has very large breasts but average sized nipples, and they do not rub on the shaft of the flanges.  She's using 27mm flanges on a Medela Pump in Style.  The pain begins immediately with pumping, and she says that when the pump goes into the letdown mode (higher suction, slower speed), she wants to scream with the pain.  She says it feels like the edges of the flanges are cutting her, and when she looks she's almost surprised to see no blood!

Her nipples look completely intact with no redness or other sign of infection (yeast or bacterial).  She never sees blanching of her nipples but says that they do turn a deep blue or purple with pumping.  She describes the pain as being on the surface of her nipples AND all over the skin of her breasts, like "the worst sunburn you ever had".  She also has internal stabbing breast pain, but the surface pain is the most pervasive and severe.  She says that anything that touches her breasts is painful, so if something brushes against her nipples this is also painful.

She has MS but is in remission currently.  I'm really not familiar with MS, but am very suspicious this may be the key.  Does anyone have any ideas to help?

Julie Conaway, RN, IBCLC
Rolla, MO

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