Just searched the archives wrt vasospasm & did not find anything quite
fitting this conundrum. Am posting with this mom's permission. This mother
has unilateral pain in her left breast. Baby is 4 weeks old, gaining great,
mom has no supply issues. Nursing is totally pain-free on RB. Beginning 1
week pp, this mom began to have pain in LB. When she called me the first
time, she described a bleb in the nipple pore. Gave her suggestions wrt
treating that. I did not know until yesterday that this recurred. She
lanced it herself the first 2 times & added lecithin to her diet per
Lawrence. 3rd time OB lanced it. First time, granular stuff came out
(assume dried milk), 2nd & 3rd times only a little blood. From her
description, it sounds to me as though 1st time she really did have a bleb.
Not so sure about 2nd & 3rd event.
Baby appears to latch well, plus the pain-free nursing on the RB suggests
this is not a latch issue, but something specifically going on with mom's
LB. Not a noticeable difference in breast size/nipple shape, etc. Saw her
feed last night & observed vasospasm post-feed. No triphasic change.
Mother reports intense pain upon latch & postfeed. Will also have pain b/w
feedings.
Mother does not report any sensitivity to cold, inconsistent w/mothers I've
seen w/Raynaud's. Plus, I've not seen Raynaud's present unilaterally. Has
anyone on the list?
Other factors of interest are that mom was GBS+, & had a BTL incision
infection @ 1.5 weeks pp, so has had 2 rounds of abx. No signs of thrush on
nipple, nor is baby symptomatic.
Only other thing I noticed is that the side of the nipple shank on one side
looks somewhat irritated.
Suggested the mom try pumping that breast just to see if there is less pain
w/pumping. She sees her OB today. I'm wondering if it is worthwhile to
culture her milk to see if she has some abx resistant strain of low-grade
mastitis. She takes ibuprofen rarely, so don't think she is masking fever.
Mom does not report any flu-like sx.
Thanks for any suggestions.
Anna Swisher, MBA, IBCLC
Abundant Blessings
Austin, TX
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