Hello,
        This is in response to the breast pain in a mom with a 5 week old
(Kathy Rubin's post 1/26).  My breasts and nipples were extremely sore
for the first 3 months of my son's life. Some pain had an obvious cause
(i.e. bleeding blisters), but much did not.  I tried many things
(gentian violet, different positionings at breast, improving his latch,
big bras/little bras/no bras, "suck training", cortisone cream,
antifungal topicals, etc.) At one point the LC in my son's pediatric
practice asked if my fingers or toes ever went white. They do, I have a
long history of vasospasm in fingers and toes.  Upon more careful
examination I did see blanching in my nipples. It was never as obvious
as that in my fingers and toes though. The pain was intense right on the
nipple, but also extended up towards my shoulder and around the back of
me.
        The pain gradually subsided, though our nursing relationship has had
some measure of discomfort for me most of the time (he's 27 months and
still nursing).  Nursing is a central part of my parenting, so I
continue and try various things to address pain as it flares.
        Having shared a bit of the history from which I speak, may I share a
few things that may be worth considering...

1) One of the hardest things for me was having people tell me it would
get better. I know this sounds odd.  IT was usually  meant to give me
encouragement, but it almost always was accompanied by a time frame
(i.e. most mothers find that they get through the rough spot in 3 weeks,
6 weeks, 2 months, etc.)  Each time one of these "deadlines" passed I
felt like there was something seriously wrong and I felt like it was
*my* fault that things weren't improving.  Encouragement was helpful
for  me, but with specific time frames less so.

2) Psoriasis *near* the nipple has been a problem for me off and on
since the early days. Lesions that appear very small may reflect skin
sensitivity that is much more pronounced.  A recent bout of severe pain
has been greatly eased by topical application of cortisone, though the
lesion was so small that I didn't notice it till my LC (with a helpful
tip from a Lacnet source!) reminded me to look closely.

3) I had heavy bleeding for some time after delivery (it was within the
range of normal lochia however). FOr this reason and because I was
exhausted! I did not resume real exercise for about 2.5 months. In
retrospect I realize that when I started that (it was just 20 minutes a
day on exercise bike) my nursing woes began to subside. I suspect that
this was many things, but quite likely related to improving circulation
(i.e. reducing problems with vasospasm) and also stress reduction.
Prior to riding the bike I was walking a lot, but I guess not enough to
really get my blood pumping.  For me vasospasm in my nipples is
noticeable but not *nearly* as obvious as it is in fingers and toes,
which go completely white, remain so and have purple, damaged tissue for
a while afterwards.  I never found hot compresses hurt my breasts, but
they certainly do my toes/fingers after an episode has damaged tissue.
FOr me blanching was only evident in the *center* of the nipple.  I
think it would be easy to miss.  Lately I have found that a scarf around
my neck helps me keep warmer while nursing even if shirt is pulled up.

4) Although my LC at the time felt Jake's suck was ok, we agreed he did
a lot of acrobatics with his tongue! Sad to say, I haven't really found
a way to address this.  I suspect that my nipples were sore and
"fragile" due to the vasospasm and psoriasis (and perhaps yeast, a yeast
controlling diet with no sugar etc. helped a little with the pain) and
that the mechanical action of his tongue was particuarly hard to take.
I found a tiny bit of relief by getting him latched then flipping his
upper lip so it was really flanged.  His frenulum was a tad tight, but
nothing my LC thought would explain our problems.  I did start taking
him off if it hurt and trying a new latch, not for the sake of improving
the latch but to try to get him to use his tongue less painfully!

        Really hope that the mom is finding relief.  Despite all the
difficulties Jake and I have had, I wouldn't trade our nursing
relationship for the world!  Good luck.
Best Wishes,
Karen Lowell

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html