I am after some help with a mother I have been working with.
Mother has b/f two children previously and no problems with this 3rd child until 2 months ago. First contact was when baby was 5 months old and mother had a blocked duct in her right breast. With freqent feeding/expressing and massage she reported that she managed to clear the blockage over night and was feeling well again by morning so did not consult GP. no antibiotics used.
Three weeks later she mentioned that feeding was still painful on that nipple and has been since the blocked duct episode.
I observed a feed, baby's attachment and feeding appeared fine. On examination of breast a white spot on the painful nipple was noticed. Discussed with mother gentle ways of removing the grown over skin.
Next day she reported she had removed the skin that had grown over that nipple duct opening, as it had not come off easily she had use her foot loofa and had rubbed it off <ouch>, she then picked out the milk plug with her finger nails. The whole top face of her nipple was now white and tender, however she felt great relief at the milk flowing again through that duct.
Over the next few days the nipple surface trauma healed and feeding again became less painful, although not painfree. The mum then reported that she was finding that duct opening was blocking up each day and would have to remove a milk plug in the shower each night, although now she was able to do this by hand expressing and gentle rubbing of that opening.
We discussed giving the nipple a bit more time to heal from trauma, being careful on attachment, feeding on all fours, cutting down on the saturated fat in the diet, taking Lethicin.
The mum has been doing all of the above for 3.5 weeks excepthas not taken any Lethicin as she "hates the stuff".
The situation now is, that particular opening is now quite large but the
milk flows very slowly from it as opposed from squirting from other ducts,
the mum visually checks this nipple after each feed on this side and will
gently hand express to make sure the duct remains open and does not block up
into a white plug, this seems to be working as the day she stopped checking
she again noticed a *plug* in that duct by evening.
She tries to do at least one feed per day on all fours over her now 7 month old
baby to really drain the breast. She is now finding that on day one she
feels well and has no pain then the next day her breast is sore and tender
and she is feeling unwell, she tries to have a quiet day and feed
lots/express etc, then the next day she is ok again, then the day after bad
again.
Other things happening is a craving for chocolate and coffee which she
reports as unusal for her. She has eliminated these from her diet for the
last 6 days.
Family history of breast cysts.
She also reports feeling gradually more and more run down as each *bad* day
she feels rotten but the good day is not long enough for her to recover
before she is bad again.
She saw her GP to ask at the possibility of getting that particular nipple
duct probed and for a general check. The Dr examined the breast/nipple and
says all is ok and as she was well that day said not to worry must have been
a wait and see thing.
I have watched another feed, everything is fine there and baby has been thriving throughout, this is an experianced mum
who believes something underlying is happening and she wants to know what.
Today she has shooting pains in that breast, no external signs of
damage/thrush. Today is also a "bad"
day for her as she discribes so she is going to see another GP.
Some things I have suggested she discuss with her GP are
underlying low grade mastitis?
Possibility of thrush within the breast? not really convinced about this.
Possibility of staph infection?
The problem nipple duct is swollen for some reason, somthing happening
internally in the breast that is subtle?
This mum is really getting run down and needs to get to the bottom of this
problem quickly so any suggestion would be greatfully received as she is
ready to try almost anything now.
I have also read today of a suggestion of calcium/magnesium for duct
spasming? can someone please explian about this?
thanks Susan
Susan Day IBCLC
Counsellor for the Kalgoorlie-Boulder group of the
Australian Breastfeeding Association
Mother to 5 breastfed daughters aged 12 to 17 months
***********************************************
To temporarily stop your subscription: set lactnet nomail
To start it again: set lactnet mail (or digest)
To unsubscribe: unsubscribe lactnet
All commands go to [log in to unmask]
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html
|
