I've been lurking for a long time, so I'll re-introduce myself.  My
name is Becky and I'm in private practice in a rural area with very few
LCs.  Most of the physicians in the area are quick to offer formula as a
cure all, so I generally have very little time to help a mother with a
problem before she is told that everything will be all better if she
just weans.

The mother I need help with is suffering from breast pain.  Baby is
almost six weeks, gaining well, latches on well.  Mother's nipples are
fine; however, she has been suffering with breast pain since the first
week.  She seems very sensitive to changes in her breasts such as any
fullness or hardness.  She has needed some reassurance that transient
lumpiness is common as the breast fills and is emptied.  She experiences
a lot of pain during feedings (in the lower quadrants of both breasts)
if the baby has not nursed for three or more hours.  Pain is much less
if she nurses more often, but she doesn't want to have to wake baby up
at night that often since he sleeps well.  Sometimes the pain also
continues for 30 minutes or so after the feeding.  Sometimes the pain is
worse in one breast, sometimes the other, occasionally they are both
very painful.

Neither she nor the baby have any risk factors for thrush and baby has
recently been checked.  She has not been ill and does not have any
redness. I've discussed MER pain, pain as ducts fill, importance of
varying positions, keeping pressure off the breast and everything else I
can think of.  This mother is ready to give up and isn't open to trying
treatment for thrush "just in case."  She sees her doctor next week and
I'm sure that will be the end if I can't come up with anything.  Any
ideas?  Thanks!

Becky Butler, MA, IBCLC
La Plata, MD