I have a question for the group.  I just had phone contact with a
mother whose breastfeeding has gone well since the birth 3 weeks ago.
She has a history of fibrosis (details are not clear) pre-pregnancy to
the degree that surgery had been recommended.  She had (again
pre-prenancy) fine needle aspiration of the lumps and they were not
cancerous.  Pre-pregnancy the lumps were most painful premenstrually.

They caused no pain the first 3 weeks after birth but now hurt as soon
as the baby begins breastfeeding and continue to hurt throughout the
feeding.  The pain is in the lumps, not areolar or nipple.

She has no history of infection during pregnancy (looking for beta
strep set up) and no generalized symptoms such as fever, chills,
headache, malaise.  The pain also occurs when she lets down while not
nursing (hot showers) and if she becomes engorged (she has begun using
bottles for relief therefore has become engorged on occasion).  They
are painfully sensitive to outside pressure.

Is this plugged ducts behind the cysts or the cysts themselves?  How
can I distinquish between the two?  Her OB has stated (sadly) that if
she wants surgery now she would have to wean first.  I asked her to get
more details on that when she sees him (soon) but shared that I am
aware of many surgeries on lactating breasts that did not mean mother
had to wean.  Also, if it is plugged ducts behind the cysts how does
she treat them since any pressure hurts so badly I don't think massage
would work.   Why did it start at 3 weeks?

She is trying to stop the relief bottles, realizing the danger of early
weaning and seeing the problems engorgement is causing her.

Many thanks in advance,
Carla D'Anna (just north of Washington, DC)


How to distinquish