Dear Hadassah,

Edith Kernerman IBCLC created a very handy "pain algorithm" for sore nipples and for sore breasts.  In the algorithm for sore breasts, for pain after feeding she suggests that the pain could relate to vasoconstriction from chest muscles and further suggests trying pectoral muscle massage, as well as making sure the latch is deep and asymmetric. I was able to order her algorithm tool as a laminated card that was published through BreastFeeding Inc Publishing (c) 2011.  It has pictures that show how to do pectoral muscle massage and pectoral muscle stretches. I hope you can still order this the pictures are very helpful.  I will describe the stretches below.

Basically, what she describes and illustrates is to hold the breast with that side's hand supporting it while the other hand massages the upper pectoralis (above the breast toward the shoulder blade), the inner pectoralis (on the cleavage), the lower pectoralis (underneath coming up form the rib cage), and the serratus (on the outer side into the armpit.)  Pectoral stretches are shown with mother standing in a doorway with her forearm placed against the wall  pointing up with hand flat and the upper arm parallel to the floor.  The mother leans in gently, keeping her whole body straight. By raising and lowering the arm, she can stretch the chest muscles in different ways.

Mothers I have suggested this to have found it very helpful.  I hope that is true for the mother you are helping.

Cindy Garrison BS IBCLC
> 
> > Date:    Tue, 7 Apr 2020 23:24:11 -0400
> > From:    Hadassah Mann <[log in to unmask]>
> > Subject: Question about interesting breast pain
> >
> > A client shared the following symptom. The "snap" part is throwing me off. any direction? History of breast abscess, but none now
> >
> > Noticed some “strange” issues on the left side. I had that weird sore spot which lasted about 24 hours.. seems to have resolved but at my 5:30 pump when I unhooked the right side the left side has this pulling pain all the way up into my armpit. Luckily I was almost done and I was able to stop before it kept progressing but it has caused me to feel sore up in that area. It was a weird pulling tingling feeling that something in there could snap. None the less it did not feel right. I don’t feel any lumps in that area. Any thoughts?
> >
> >              
> 
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