This is an update on the RN, with the 4 month old, who called me with severe
breast pain.  She cancelled our appointment to assess for a plugged duct or
plugged nipple pore because her husband, a Radiologist, had decided to treat
her after conferring with some OB/GYNs and surgeons.  She was hesitant and
somewhat fearful of proceding with his treatment but stated that he would be
angry if she did not comply.

Today she phoned me and I quote, "The procedure was not successful.  He tried
to numb my nipple before beginning the treatment but it was difficult to numb
such a  tender area; the injection was so painful as it was inserted into the
nipple.  This whole procedure was very, very painful -  it felt like I was
going through labor.  He threaded a needle through my nipple with an
angiocath attached (just like starting an IV) - while visualizing the breast
on ultrasound.  To hold the angiocath in place he stitched it to the nipple -
which was also really painful.  Everything was bandaged and I went home.
 About 4 hrs. later, due to the discomfort, I opened the bandages.  Instead
of breast milk coming out of the tube, as we had hoped, I discovered I had
gotten a blood clot in it.  The rest of the breast was knotty and engorged
and it was a mess - so that was the end of that.  I put the baby on formula
and he is doing just fine."   She was much calmer than our earlier
conversation previous to the procedure. (Incidentally, the culture showed no
signs of infection.)

She has now been advised by the medical community to immediately wean so she
has stopped breastfeeding and is icing her breasts periodically; they are
beginning to soften.  She confided she has some concerns about weaning since
she really enjoyed breastfeeding and, as a Catholic, breastfeeding has been
her only means of birth control.  Mothering a two year old and a 4 month old
baby has been a real struggle for her with the toddler being very hyper and
sometimes abusive to the baby. She proclaimed she is not ready to get
pregnant again.

She has considered continuing to breastfeed on the healthy breast only but
all the doctors her husband approached advised him that it was not possible
to nurse from only one breast.  They also said that the baby would only
benefit from immunities in the milk for the first few months and then there
would be no real benefit to breastfeeding.  The Lactation Consultant (IBCLC)
at the hospital offered similar information to them.  This mother said the LC
told her that both she and I had the same certification and training (which
we do not!!) and therefore we would both have the same breastfeeding
information.  She wanted to know if I felt these things were true.

First, I congratulated her for starting out nursing and continuing through an
entire month with a painful breast.  I told her she deserved a lot of credit
for her determination to continue nursing even when it meant submitting to
such a painful procedure in order to try to remedy her situation.

I did point out that the hospital LC and I both had the same certification
but had been trained very differently.

Then I told her that she should be aware that not all physicians are
knowledgeable about breastfeeding or a disease process related to
breastfeeding.  I explained that most physicians receive little or no
training related to breastfeeding in medical school and may be misinformed
about  breastfeeding anatomy and physiology.  It is possible to nurse from
one breast long-term and I gave various examples.  We also discussed the
benefits to mother and baby in continuing to breastfeed.

I told her the decision was hers.  It all depended on where she was at with
all of this and where she wanted to go.  I said I was very much willing to
help her if she decides to continue breastfeeding.  We also discussed
techniques in weaning which were healthier for breast tissue than abrupt
weaning.

"I would really like to continue nursing.  I love nursing.  My husband and I
are discussing it.  But he has said if I get into trouble again with problems
in my breast -  I am on my own.  He doesn't want to hear about it!"


As you can see, this man has a great deal of control over her life!

Carolyn Zara, RN,BSN,IBCLC  (who gets so tired, angry and frustrated with
breastfeeding situations that are mismanaged by misinformed health
professionals.)