Hi Kika,
This doesn't specifically reply to your question on lactnet. However, you
mentioned elimination of other causes, including referred pain from nipple
trauma.
I would like to add another cause of referred pain as a factor in
persistent breast pain in lactating women. That is, a history of a spinal
injury. If it is in the region which the enervation of the breast comes
off, that is more obvious, but my experience is that past injury to other
areas of the spine can occasionally be implicated. Postural change
is likely to be one of the factors - late-pregnancy postural changes, then
delivery, and then the position the mother uses for breastfeeding if she is
hunching forward (as some do). That's not the whole story, of course, and
perhaps someone will explore whether there is a hormonal link, such as
oxytocin surge.
However, it has been interesting to find in some puzzling cases of severe
and generalised breast pain, that there is an association with past spinal
trauma. I send the mother back to whoever was treating her for her pain
after the injury, for attention to pain relief, and ask her to come back to
me after that. She is unlikely to concentrate on the breastfeeding
consultation with a high level of pain, but once that is addressed she and
I can make progress.
Yes, there are some cases of chronic, severe breast pain that really
challenge us as regards finding a solution, even when 7-8 possible causes
have been eliminated, including the possibility that it is multi-factorial.
(I am in the process of moving house, to a neighbouring city.)
Virginia

Dr Virginia Thorley, OAM, PhD, IBCLC, FILCA
Private Practice IBCLC
Queensland, Australia

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome