My approach with mom's with such severe deep breast pain is to rule out 
latch, oversupply, dermatitis, vasospasm and neuropathic pain first. 
However, I find that the vast majority of this sort of pain is due to a 
dysbiosis, with bacterial overgrowth in the breast. Some studies call 
this subclinical mastitis. I call it a bacterial lactiferous duct 
infection. It is not unlike bacterial vaginosis, where there is an 
imbalance of bacteria in the vagina causing pain/itching.
I suggest a breastmilk culture, and treatment is typically an 
antibiotic. I will add an antifungal if the baby has had recent thrush, 
or mom's nipple/areolar complex appears thrush- like.
This is a very common issue in the dairy industry (goats and cows), and 
is seen experimentally in mice.
I have excellent success with antibiotic treatment, but it is a long 
road of treatment. It is a very common problem, and I see at least 8-10 
of these cases each month.
Anne

Anne Eglash MD, FABM, IBCLC
Clinical Professor
Dept of Family Medicine
Medical Director UW Lactation Clinic
University of Wisconsin School of Medicine and Public Health

             ***********************************************

Archives: http://community.lsoft.com/archives/LACTNET.html
To reach list owners: [log in to unmask]
Mail all list management commands to: [log in to unmask]
COMMANDS:
1. To temporarily stop your subscription write in the body of an email: set lactnet nomail
2. To start it again: set lactnet mail
3. To unsubscribe: unsubscribe lactnet
4. To get a comprehensive list of rules and directions: get lactnet welcome