FYI  About 7 months ago this case was posted below is the outline of the case 
and the outcome:


INTERESTING CASE
This nullip mother-to-be is 16 weeks pregnant and presents with bilateral 
deep breast tenderness and quite pink flushing of the skin, what you might 
see with engorgment or  mastitis  ( In Fact before I knew she was pregnant I 
asked her if she was breastfeeding).  These symptoms started May 31st.  The 
flushing is most markedly noticible over the lower half of both breasts (4-8 
o'clock).  the skin looks slightly dry, flakey and is nontender.   I cannot 
express colostrum and the breast exam feels like normal firm glandular 
tissue. The axillary nodes maybe a little swollen but soft.  Lying down and 
supporting the breasts with a bra relieve the discomfort.  Interestingly 
lying down lessens the flushing of the breast as well.  Ice and cold 
compresses also relieve discomfort. 

No fever, aches, minimal or no response to keflex, US negative, CBC and C&S 
pending. 
She is on Aldomet for hypertension.

She will try Augmentin, massage, warm showers alternating with cold cabbage 
compresses over the weekend.  

I am at a loss for a Diagnosis/Etiology---Any ideas?     TIA   Chris  Betzold 
NP IBCLC MSN


This is the outcome:

She seemed to improve when Aldomet was discontinued. Tthere was no response 
to antibiotics. Wearing a bra continuously also helped the symptoms.  The 
surgeon eventually diagnosed her with a Vascular Overreaction to the Hormones 
of Pregnancy.  Postpartum the symptoms resolved and she is successfully and 
exclusively breastfeeding a 2 month old infant.  She has not developed any 
infection despite oversupply with an overactive let-down, which has imporoved 
with one-sided feedings and using the Australian hold.  Her infant did 
experience some reflux and colic, which did not respond to Zantac, but did 
respond to the above measures.  


Thanks to all who responded and helped me with this mother.  

Chris Betzold NP IBCLC MSN

<A HREF="http://www.starfireinternational.net/breastfed">http://www.starfireinternational.net/breastfed </A>


Christine Betzold NP IBCLC MSN
www.starfireinternational.net/breastfed






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