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Date: | Sat, 22 Apr 2006 20:18:49 EDT |
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Jaye writes: "Approximately 10-20 minutes after the first feed that pain
starts in nipple
with burning sensation then progresses to excruciating, shooting pain
(lightening bolt type) through center of breast sometimes angling out to
underside of breast. This pain lasts for 3-4 hours.'
These sx sound like intraductal yeast but I would expect sx to occur
throughout the day, not just with the first feeding. I am guessing that since baby
began solids and is older she is now going all night without feeding and that
the first feeding from each breast is after a prolonged period without
emptying. I would have the mom try an experiment: get up after 3.5-4 hours and
empty breasts, the goal being to not go longer than 3 or 4 hours without
emptying. If this alleviates the problem the pain is probably due to refilling or
some kind of spasms as the ducts are emptied. She says breasts are not over
full, but at 8 months she is probably not experiencing the same sensations
of overfullness that she did early on.
Jaye also describes that "Nipples are more pink than areola - one nipple
looks almost purple - BOTH have little white dots on the face of the nipple (one
more so than the
other) - the white dots look like they are under the surface of the skin
with a pink haze over them."
I have seen nipples that are pretty pink with almost a line of demarcation
and areolae are not--these moms have excema (you state this mother does have
excema). A trip to the dermatologist could be in order. I'm not sure about
the little white dots and the purple nipple. She also may be reacting to
food left in baby's mouth when he starts nursing.
And, of course, mother COULD have intraductal yeast which would need tx
with diflucan, but I would expect the pain to occur at times other than the
first feeding on the breast.
Finally, I'd have mom look at the nipple for a few minutes the minute the
pain starts to see if there is any blanching, etc.
Let us know how this turns out. She may have a mixed bag of things going on.
Kathy Boggs, RN, IBCLC
Mountain View, CA
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