Christine,
 
I'm wondering what this mom's nipple looks like post feed?  Is it  
compressed, misshapen in any way?  If so, the pain she's experiencing is  likely 
nerve pain and latching and infant suck on that side should be  assessed.  
Sometimes infants have difficulty using one side of their body  due to mild 
asymmetry or tongue elevation is asymmetrical.  Moms also can  have difficulty 
positioning baby on one side more than another due to their own  body 
mechanics.  My suggestion would be to trouble shoot these things with  mom/baby and 
refer them both for chiropractic, CST, or other form of  bodywork.  Mom 
leaning over could cause pain, too but the nipple bleb  mentioned makes me 
think it has to do with latch or suck; of course it could be  both.
 
Barbara Latterner, BSN, RN, IBCLC
Brewster, NY
 
 
 
I would be grateful for some advice for a mother of a 6 week old baby.  This
is her 2nd baby but she did not breastfeed the 1st child. She has pain  over
the inner upper quadrant of the left breast which begins shortly  after
feeding & can persist for several hours after the feed. She also  describes 
a
pricking sensation which occurs occasionally on the outer aspect  of the
breast. She is currently mixed feeding, some direct breastfeeds,  bottle
feeding EBM or formula. Mixed feeding was commenced on 2nd day post  partum 
-
baby was kept in nursery on 1st day ! Mom was given antibiotics post  
partum.
She has been treated by her paediatrician : -initially she was given  
topical
treatment for thrush. As there was no further evidence of  thrush  & the 
pain
persisted, her doctor prescribed antibiotics.  Paediatrician also burst a
small milk bleb on the left nipple &  prescribed motilium to help increase
milk supply. Mom is seriously  considering stopping breastfeeding due to the
pain - her dr prescribed  panadol. Have advised her on positioning &
attachment as there is still a  small abrasion on nipple tip. She does lean
forward to breastfeed  ?  possibility of referred back pain  ?? ductal 
thrush
but it only affects  one small area of the breast. She has no discomfort at
all when expressing  with her double electric pump. ? whether anti
inflammatory meds may be  helpful.
I would appreciate any suggestions.
Many thanks,
Christine  Choong  IBCLC


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