I apologize in advance for the length of this post, it is just that I want to get
the details right, because it's a little unusual and I'm pretty sure it is not
ductal yeast, though if I don't describe it in detail, I think that would be the
logical conclusion.
I am working with a woman who is five weeks postpartum. She has extreme
pain "like my left breast is on fire'" about an hour or sometimes sooner after
nursing. Nursing itself is pain free, she describes the pain coming as her left
breast is filling with milk and is experiencing intermittent, simultaneous
neurological symptoms, numbness and pain in her arm extending to her hand.
When she nurses the baby, the pain is relieved, though she can't bear to put
the baby on her breast until she expresses about 5 ml of milk.She also
experienced this in her right breast to a lesser degree, though that has
generally resolved. She does not have oversupply, the breast is completely
soft after feedings and if she tries to empty more with a pump only gets a
few mls following feedings. Several test weights showed the baby took in
between 2.5 and 4 oz per feed. Lawrence desctibes this type of situation, and
suggests that it is caused by pressure on nerves in the axilla from
engorgement in the tail of spence, though she doesn't describe the "breast on
fire" sensation. Just to complicate matters, this woman also experienced
painless blanching of her nipples during the first couple of weeks postpartum,
though she says that with her burning breast sensation now, there is no
evidence of vasospasm., no nipple color changes at all.
Have any of you come across anything like this and what did you do???!!!
Cabbage and ice have been somewhat helpful as has Sudafed, but she doesn't
feel like she can take continuous Sudafed, and I find that concerning as well.
Her supply is extremely average and I am worried about down-regulating it.
Lawrence says that this usually resolves within several weeks, as
engorgement settles down. But she is reaching the end of her rope and I am
hoping someone out there in lactation world has a magic bullet...
Thanks for any ideas,
Kathy Lilleskov RN IBCLC
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