Cindi The first thing I would think of with the presentation you gave would be yeast. It sounds like a pretty classic presentation of new nipple pain after a period of pain-free feeding (3 wks), pain inside the breast and radiating to the back. Even though the mom/baby did not have the predisposing condition of abx use, it could still be yeast. Sometimes it is a muscle or nerve pain due to positioning issues or even a poor latch with clenching type suck. I usually ask the mother if she is noticing any vaginal yeast symptoms, if the baby has *any* patches on the mouth area, if the baby has any diaper rash symptoms. Sometimes this reveals some yeast evidence. Does she notice any difference in the appearance of her nipple/areola skin, often it is red, pink, shiny, inflamed looking. Anyway, I would proceed from this standpoint first, unless I could uncover anything else in a more thorough history taking. Laurie Wheeler, IBCLC, MN, RN New Orleans Louisiana, s.e. USA _________________________________________________________________ MSN 8 with e-mail virus protection service: 2 months FREE* http://join.msn.com/?page=features/virus *********************************************** 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