I'll probably go beyond my 3 posts, so I'll combine 2 topics; sorry.
 
extreme breast pain: the mother could have mastitis and/or abscess; mastitis could be bilateral. Fissures are a portal for bacteria. I had a breast abscess with strep bacteria and it was exquisitely painful. 
 
recertification: personally I don't mind the test, I've taken it 2 times and I didn't find it unusually difficult. The traveling and hotel expenses were somewhat of a hardship. I would like to be able to test at a local site with a proctor perhaps. It is very difficult for me to travel away from home. I have found it difficult to find conferences nearby, affordable, and ones that give advanced information. I will likely take some online courses to recertify for 2007. Laurie Wheeler, RN, MN, IBCLC
Mississippi,  s.e. USA 
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