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Subject:
From:
Alicia Dermer <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 31 Oct 1995 23:45:38 -0500
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Hi, 'netters:  I'd appreciate input from any and all comers.  Last week,
I spoke to a woman who had nursed nine children.  One of my IBLCE study
partners (a LLL leader) had recommended that she speak with me.  About
two months ago, two weeks after cutting down from 4 nursings to 3 per day
with her then-9-month-old, she developed an enlarged, tender left
breast.  She did the conventional treatment for plugged ducts and
engorgement, with relief of plugged ducts but persistence of the enlarged
painful breast.  Since there was deep burning during nursing and
afterwards, she self-treated for thrush although she didn't treat child
(no signs in child; mother had often self-treated in past successfully
for thrush without treating her children); she had had no signs of nipple
redness or cracking, but continued to have a large, tender breast, nipple
soreness; saw her Ob/Gyn who examined breasts and found nothing unusual,
told her that her left breast was engorged.  The patient was at her wit's
end, having severe pain usually immediately after the morning nursing,
lasting 1-2 hours despite ice packs, heat, massage, etc.  I told her that
she needed to come and see me, and of course in the back of my head with
a 43-year-old woman I couldn't dismiss the possibility of an inflammatory
breast ca.  She was about to make an appointment with me when she tried
cabbage leaves on another leader's recommendation, and within 2 days had
75% reduction in her symptoms; thought she was cured, was even able to
wear her underwire bra for hours again without problems (had worn it
forever throughout all her breastfeeding career without problems); 4 days
later, after another social event with a few hours of wearing her
underwire, she developed same symptoms again; came to see me today, exam
unremarkable except for a significantly larger but not very firm left
breast, slightly tender, no discreet masses.  Mother was told that
weaning would resolve this problem, but it started when she had cut down
feedings.  She is ready to wean (she is definitely not willing to
increase frequency of nursing), but worried about discomfort.  I told her
regardless of whether or not she weans, if the symptoms persists she
needs to see the breast surgeon at our local breast center (she is a LLLI
Medical Associate).  Does anyone have any ideas for this lady? (By the
way, although the left breast has always been this child's favorite, it
was never this big, and there's plenty of milk production in the other
breast.  I also asked about blanching, she rarely saw it.  Another
thought, she tried the cabbage leaves again this time, and they didn't
seem to help)  TIA, Alicia.  [log in to unmask]

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