Dear Friends:
    This is a phenomena that I have observed in many women, besides me. With
my first baby, I would feel sharp pains in my breasts that felt like a knife.
I have heard women report that the breast "balls up and gets hard" briefly at
the beginning of a feed.
    Lawrence reports on this. And after listening to Peter Hartmann talk
about the observations his group has made, I have a hypothesis. Dr. Hartmann
says that during the milk ejection reflex, the whole duct dilates, from
nipple pore back into the glandular tissue. Perhaps this opening, or widening
is what gives rise to the sharp sensations.
    The differential diagnosis between first minute latch-on pain and pain
from thrush or poor latch or clenching or anything else is that the FMLOP
goes away within a minute and is usually gone by the end of the first week or
two. Telling mothers what it is, encouraging them to drop their shoulders and
imagine rivers of flowing milk all help her through this phenomenon.
    I suspect that it occurs more often in a primalacta, a woman having her
first lactation. What do you all think?
    Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative

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