If there is no fever and no body aches ect, it doesn't appear to me to be
bacterial mastitis. (Again, as someone said Ruth Lawrence has some info on
this) I have worked with mothers, (and experienced myself) pain, lumpiness
and other smpx like these prior to menses. Many women also experience sore
and painful nipples. My currently nursing almost 4 year old also
complains  "I want you to make me more milky" at this time. It usually only
lasts a day or three.

I would suggest fluids, rest frequent nursing and some Motrin or other
antiinflamitory. (In other words treat it like a blocked duct.)

One of the docs at Homefirst always insists that women who don't have
enough sodium in their diet are more prone to plugs as well as mastitis, I
don't know if there is research to this fact, but it seems to hold true. I
saw this resolved with adding some sodium to the diet, in the late 80s and
early 90s when *too many* people, including pregnant women and nursing
mothers, were following a severely sodium restricted diets for no real
medical reason. Adding some salt make at least some of these mothers more
comfortable.

It may be that there is some ductal tissue that does not have an outlet,
but why would this only occur during menses? I am thinking this is
hormonal, and plugged ducts, whether palpable or not, seem to be more
common in some women before menstruation.

Mary Jozwiak IBCLC, RLC, LLLL, AAPL
Private Practice

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