Allyson makes a good point about the possibility that deep breast pain can
be coincidental with breast feeding.  It can result from strained body
mechanics that communicate as what might more accurately be labeled "chest
pain."

 Susan Love, MD describes costochondritis as a type of arthritic pain that
is felt under the breasts.  She also describes a "non-breast pain"  (meaning
it doesn't orginate IN the breasts) from "...arthritis in the neck -- a
pinched nerve."  Further, she describes:  "...a special kind of phlebitis
(inflamed vein) that can occur in the breast, called  Mondor's
syndrome...sometimes you can even feel a cord where it is most tender."  She
goes on to describe anti-inflammatories as appropriate therapy and states
that these pains are generally self-limited and go away in time.  S. Love:
Susan Love's Breast Book, 3rd Ed, Perseus Publishing, Cambridge, MA.  2000.
Pg 91-92.

I would support the idea of getting body work (chiropractic, massage, CST)
for postpartum women as so many have strains from long pushing stages, or
have had poor body mechanics during breastfeeding.

Further, there is an interesting new article that one of my Australian
friends shared with me:  L Barclay:  Duct Ectasia Linked to Mastalgia
Severity, Obstet Gynecol 2003; 101:54-60.

This article makes the point that breast pain is poorly understood, that
ultrasonography is useful in exploring the structures of the breast, and
that women with breast pain tend to have wider duct dilation.  Certainly
some of these women (my extrapolation) will go on to breastfeed.  Perhaps
they start out with structural issues that predispose them to more
discomfort.  We know from Donna Ramsey's work that ducts dilate when the
milk ejection reflex occurs.  Does this translate into an experience of
discomfort to women who have wider ductal diameter to start with?
Barbara Wilson-Clay, BS, IBCLC
Austin Lactation Associates
LactNews Press
www.lactnews.com

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