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Date: | Sun, 20 Oct 2013 17:47:12 -0500 |
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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
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