Re: Ros Escott's woman whose non-lactational nipple pain resolved with
evening primrose oil (EPO).
Her symptoms would be regarded as "cyclical mastalgia" because pain was
worse premenstrually. 58% of women with cyclical mastalgia improve with
EPO, according to R.E. Mansel. Dose: 40mg, 6-8 daily in divided doses.
Trial of treatment should last at least 4 months. This is from a book I
ordered recently: ABC of Breast Disease, BMJ Publishing Group, 1995, Ed
JMDixon [very medical, with colour photos of breast diseases, would be of
interest to some LCs].
Some people have used EPO for lactating women with breast pain, but I
don't think it's been well assessed.

Re: Oily nipple discharge on expression.
The book mentioned above says spontaneous nipple discharge should be
investigated with clinical examination and (if over 35) mammography. They
say physiological nipple secretion can be obtained in two thirds of
premenopausal women by applying suction. The colour of the discharge:
white, yellow, green, blue-black. I think this reinforces what somone
said earlier: if the secretion is not spontaneous it is not likely to be
a problem. (Of course, she should still see her doctor).

Lisa Amir
GP / IBCLC in Melbourne, Australia