Hi Barbara,
Yes, the Thomassen et al article is interesting. But I think it is very
arbitrary to divide women into "superficial" and "deep" pain. If you count
up the women who were positive for candida in the pain group and compared it
to the control group - this was a significant difference. Yet, because the
researchers found less candida in those with deep pain than superficial pain
they "dispute the theory of Amir and Pakula". (Ouch! No, I didn't "invent"
the idea that candida could cause breast pain).

Most of the women had cracked nipples, and as Barbara said probably bacteria
are involved as well as fungi.

When you go the library to find the article, you may want to look for my
reply (written with my colleague Susan Donath) published the following year.
Amir LH, Donath S. Breast-feeding, pain and infection (letter). Gynecologic
and Obstetric Investigation 1999; 48: 145.

Looking back in the wonderful Lactnet archives, I found a conversation
between myself and Barbara W-C in September 1998 about use of low -dose
antidepressants for neuropathic pain.

Lisa Amir
MBBS, MMed, IBCLC in Melbourne, Australia

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