I have just been dealing with a similar case.  Baby is 4 weeks old and
mom just came to us because of "pain 80% of the time since 5 days".  She
reported "burning" and "shooting" pain and the nipples were slightly
pink, but otherwise no s/s thrush.  There were one or two tiny white
spots on baby's tongue (no larger than half a pinhead size), no diaper
rash.  We did discuss possible thrush, but since there were such minimal
thrush indicators, I tried looking for something else.  Baby had been
gaining VERY well, in fact mom questioned whether it was possible for
her to be gaining too fast.  Output within expectations.  Mom was large
breasted, so observing baby at breast was a little more challenging than
with average size.  Latch looked good initially, and there was great
evidence of milk transfer with baby having no difficulty such as fast
flow.  When I reached a finger under mom's breast, however, to get a
closer look at the latch, I did note that baby was clenching the jaw.
(Something that would have been more obvious with average size
breasts.)  We tried repeatedly to improve tha latch, but each time mom
stated there was no improvement in what she felt.  Finally, out of
desaperation, I tried a shield.  I seemed to remember a previous report
about this relieving the clenching.  Sure enough, mom immediately
reported it was significantly more comfortable.  We're going to see what
happens over the next couple days, then reevaluate and possibly refer
for thrush Rx if things aren't significantly better.  While I'm not
ruling out thrush yet, I think it may be that baby's constant clenching
was a significant factor in mom having shooting pains even after
nursing.  Incidentally, there was no blanching or other evidence of
vasospasm.
Has anyone else had a similar experience?

Winnie Mading

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