Hi All,
I'm working with a woman who gave birth 9 days ago. Beginning in her third trimester her already fibrocystic breasts began to bother her. They felt sore and uncomfortable. When her milk arrived 4 days after giving birth she felt that the milk was pressing on all her multiple cysts and pushing them up toward the surface of her breast and making them hurt. The lumps are scattered throughout her breast and range from prune sized to cherry pit sized. She has lots of the little cherry pit sized ones around her areola and they are particularly bothersome when the baby nurses.If she pumps her breasts til they are soft she can get rid of the pain for a little while, but then as soon as her breasts partially refill multiple  cysts get pushed to the surface and are painful. She is particularly bothered by the ones that are near her areola when she nurses and by the larger cysts on the outer aspect of both breasts.

She seems to have about 3 to 4 oz of milk per breast when they are full. I am reluctant to have her empty them following each feeding because I don't want to encourage oversupply and have suggested pumping just for relief as needed. She did try emptying them once a day for a few days to see what happened, but this only seemed to increase her production, though immediately following pumping she was comfortable for about a half and hour. Does anyone have any suggestions for management of this scenario so that we can reduce the pain she feels. She is going to be ultrasounded on Monday to take a look at what is going on inside her breast. I have suggested she stop drinking the cup of coffee she has in the morning and she herself has discovered the importance of massaging her breast to encourage milk that seem to be blocked by the cysts to move through and I have suggested lecithin prophylactically because I am concerned that all these cysts may lead to plugged ducts, but I don't know if there is any way I can help her manage the pain.

Thanks for any suggestions,
Kathy Lilleskov RN IBCLC

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