Yes Virginia, it is often multifactorial...

Last month I discovered a new (for me) diagnosis for chronic mastalgia: it
was the mother of a two month old baby, consulting for pain in her right
breast that had been growing worse for the last month. Pain began around
the middle of the feed and lasted well past it. Lately it was almost
constant.
There was no sign of nipple damage, baby was latching, feeding and gaining
well that I could see.
I left mom breastfeeding on the couch while I sat to write down her
history. I do this while I watch the dyad and they don´t know I´m watching,
it gives me a lot of information. So the mom picks up her phone and starts
to text at vertiginous speed, non-stop. With her right hand. When baby is
done he unlatches, mother offers other breast, and keeps texting. I see
mother is wiggling on the couch trying to find a comfortable position for
her arm/hand while she is texting.

Yes, this mom had "whatsappitis".

Fisiotherapy for her pectoral and cervivcal muscles and a
hands-off-phone-while-breastfeeeding policy cured her mastalgia.

Love the detective work!




> Date:    Sat, 27 Jun 2015 11:03:12 +1000
> From:    Virginia Thorley <[log in to unmask]>
> Subject: Fwd: Milk culturing in chronic breast pain and referred pain
>
> 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
>
>
-- 
Dra. Carmela Baeza
Médico de Familia
Consultora Certificada en Lactancia Materna IBCLC
www.centroraices.com
http://www.facebook.com/Consulta.Lactancia.Raices
<http://www.facebook.com/pages/Centro-de-Atenci%C3%B3n-a-la-Familia-Ra%C3%ADces/274415189309122>

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