Dear lactnetters,

Again i need input to help deal with a problem. i have checked the archives
and books but do not find anything suitably helpful.

A G3 P2 30m year old women presented at 34 weeks with what she describes as
severe shooting breast pain when she describes her attempts to breastfeed.
she identified that she wants to breastfeed but finds it extremely painful
and was in tears anticipating the situation for this baby. She had mentioned
her situation to three other health professionals so far in the pregnancy in
an effort to ask for help. the first baby was 6 weeks early . she breastfed
for six weeks then "ran out of milk" the pain was there at the time but not
as bad as with the second baby. The pain was so severe with the second baby
that the LC in attendance at the time encouraged her to express and feed
baby by bottle. this she did for six months. Now she is not looking forward
to expressing and then  bottleing so has stated she is prepared to do it for
3 months if necessary but would love to find a solution to the pain. The
shooting pain she experiences even now in her pregnancy is upsetting her.

We discussed thrush. and a possible course of systemic antifungal medication
in the last month of the pregnancy. we also discuss application of gentle
warmth  postnataly to the breast to reduce the liklihood of spasmnm in the
breasts.  (we did not discuss or broach sexual abuse matters).

she had now bought some accessaries form ABA for warmth application
postnatally. she is more relaxed to day than three weeks ago. I understand
this lady genuinely wants to find help to her problem and is seeking out
what she can before the vent to prepare. does anyone have any ideas of what
else could be done  and how we can help her to enjoy her feeding relation
ship with her third child . she will end up with three children under the
age of four years old.

Thank you all fo your input.
ruth cantrill

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