In my opinion this type of pain is almost always due to candida and responds
to high doses of fluconazole as in my protocol.  If the mother has nipple
pain, treatment locally with gentian violet and all purpose nipple ointment
may do the trick.

Other possibilities:

Raynaud's phenomenon can seem to be in the breast.  The nipple is blanched
while the pain is there (burning), throbbing when vessels refill (not
always).

Could be due to the heaviness of the breast, I guess, but why only after the
feeding, when presumably the breast wouldn't be heavier, but lighter.  I
don't believe in this refilling story.  I also don't think the mammogram or
other investigation is going to show anything and are a waste of time and
money.

Neuropathic pain could also present like this.  Often there is a
precipitating factor.  Treatment is with amytriptiline, apparently.  I have
no experience with this and the doctor I wrote to find out more (I posted
about this before) has not responded.

Jack Newman, MD, FRCPC

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