Today I was working with an RN/LC.  We saw a mother who was complaining of
breast pain (bilateral), deep, shooting, stinging pain.  The baby is 4 months
old, a 2.5 lb premie who is completely breastfed and gaining well.  Her
breastfeeding is interesing in that she tugs and pulls at the breast, chomps
a lot until the MER and then settles fairly well into an effective
suck/swallow routine.

Mothers nipples are tender and a little pink.  She is in her late 30's and
has had a history of fibrocystic breasts.  She also had an area that looked
somewhat red/splotchy from 9:00 to 11:00 on the right breast.  She has had
problems with plugged ducts but when I saw her they were all drained, no
lumpiness.  The mothers menstrual cycles returned two weeks ago.  Mom had not
run any fever lately but complained of a generalized unwell feeling.  Her
voice sounded weepy and she was frustrated.

The RN/LC I was with told this mother that the pain she was experiencing was
due to nerve damage from the babies sucking pattern and from overdoing it
with the pump when the baby was in the NICU.  She said that the pain wouldn't
get worse but it wouldn't may get better at times.  She recommended Motrin
and anti-inflammatories for the discomfort.  After some further discussion
she agreed to recommend dicloxycillian for 10 days with 1 refill but she felt
certain that it wasn't a breast infection.

She also told the mother that if she were to go to a doctor for it (within
the med center) she would most likely be told to wean the baby.  At this the
mother became very upset.  She is very determined to continue breastfeeding.

My question is:
     1.  Have any of you heard of nerve damage causing this type of pain?

     2.  Is there any documented evidence that fibrocystic breasts tend to
have more problems with plugged ducts and/or filled ducts?

     3.  How do women's hormone cycles affect the fibrocystic breasts and the
tendency they may have to get plugs?

Denise Parker, B.A., IBCLC