Dear Lactnetters,

This mother has given me permission to copy her letter to the list.  She
would be very interested in your comments. Maybe we should be using
nifedipine in those mothers who don't respond to treatment for Candida.
Please email her directly as well as to the list, but not to me.  Her email
address is [log in to unmask]

Jack Newman, MD, FRCPC

"I have recently had my fourth child.  I have experienced breast pain with
all 4 children although it has been the worst with the last 3.  My pain
begins with my let down.  It hurts so bad I can't talk through it - it feels
as though my nipples (both sides) are going into 'charlie horses'.  After
the initial pain I have some shooting pain that goes deep into my breast but
usually all pain subsides as the baby continues to nurse.  Unfortunately it
all begins again if there is at least a 20 minute lapse between feedings
(talk about incentive to breastfeed frequently!)
I also have a lot of deep breast pain between feedings.  It feels like
'charlie horses' or muscles spasaming deep inside my breast.  It keeps me
from sleeping at night as it hurts so much every time I change positions or
bump my breasts.  I also suffer from one clogged duct after another.
I have been treated for thrush although all babies and I have never shown
any symptoms.  This has not changed anything.
I am a La Leche League Leader and I have checked for improper latch on and
had other leaders come to observe and try to find any possible latch-on
difficulties.  They seem to be latched on perfectly.  I have no pain at all
from the baby nursing - leaving them latched on for a long time actually
significantly reduces my pain.
I do have Raynauds phenomenon (since I was young) so I decided to try
Nifedipine.  After a few days I did notice a signigicant difference
(especially when I had a let-down).  Since I have been taking Nifedipine I
have not had one clogged duct and my deep breast pain has almost gone away
 it certainly doesn't keep me awake at night anymore).  The thing that is
disturbing me is that I have to take quite a high dose for it to work (40mg
of slow release/day) and I have been taking it for just over a month now and
everytime I try to wean off of it the pain returns.  Whenever I read about
Raynauds phenomenon related breastpain it doesn't seem to exactly describe
my situation.  I keep wondering if maybe this is not the problem I really
have but the medication is maybe altering my body in other ways and making
the pain less intense.  I seem to be just taking wild stabs in the dark
treating this as my doctor has never heard of anything like this.
So, I just thought I would tell you my story as there is always a chance
that I may stumble across someone that recognizes my situation and has some
solutions to offer.  You never know unless you ask!!  In the meantime I am
enjoying the break from the intense pain.  Thank you for taking the time to
read and consider this situation!"

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