I'm looking for some pearls of wisdom.  I 'm an independant midwife and have a client who is breastfeeding her 4 week old baby (I have permission to post).

A difficult start to breastfeeding after a c/s.  Initial feed very good, then poor feeding over the next few days.  Flat nipples and large breasts. Inconsistent help and advice in the hospital.  However, mum and babe developed a good latch technique and were doing fine once home.  Some minor nipple grazing, but no significant damage.  However mum continued to experience nipple pain while feeding during week 2.  This pain has subsided but has been replaced with a significant pain under arms, shoulder blades and front of chest as the baby starts to feed.   She describes it as deep pain. I thought this may have been an over strong let-down reflex, but am not sure.  Milk supply and weight gains only just adequate (due to the pain with feeding I'm sure). I really don't think this is thrush (which I am reasonably familiar with).

Mum has large breasts and a poor posture at the best of times.  I wonder if this is muscular/skeletal.  The pain is so distressing I feel she will give up breastfeeding soon.  I have prescribed pain relief but this dosn't solve the problem .  Any thoughts,

Karen Palmer
New Zealand 


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