Hi Kika

I'm so glad to hear you're still trying to sort out the issues of 
unresolved breast pain.  This is a really under-researched area, and 
we need more answers.  You're asking some great questions that I 
can't help with, unfortunately, but I'd like to add two points.

1.  When I was a busy LC in Harare, Zimbabwe, several doctors and I 
came across women with on-going severe breast pain and/or nipple 
pain, which seemed like Thrush (a popular diagnosis at the time), but 
on culture the offending organism turned out to be Staphylococcus 
Pyogenes.  This was so unusual that the first time it was identified 
the lab requested another milk sample because they said that the 
container must have been contaminated.  I eventually collected 14 
cases, always meant to try and write them up as a paper, but never 
did..... Treatment was with an appropriate antibiotic and it was 
difficult - there was often no inflammation, just this excruciating 
pain, described as like hot needles deep in the breast or having 
ground glass on the nipples - and the doctor might have to prescribe 
two or three courses of antibiotic before the pain finally resolved.

2.  To add to Virginia's excellent post on spinal injury as a cause 
of breast pain, I recently had a client who complained on and on 
about blocked ducts, describing breast pain, but no other symptoms 
consistent with over-production or blockages - in fact her baby had 
been quite underweight and she was working hard to increase her milk 
supply.  Eventually her GP diagnosed costochondritis.  I'd never 
heard of it!   But I found this info 
at 
<http://www.patient.co.uk/health/costochondritis>http://www.patient.co.uk/health/costochondritis 
"In costochondritis, there is inflammation in either the 
costochondral, costosternal or sternoclavicular joints (or a 
combination). This causes pain and tenderness, that tends to be worse 
with movement and pressure."  The doctor suggested ibuprofen for 
pain, and to stop hunching over while she breastfed her 
baby!!!  Something I'd suggested too, but obviously not strongly enough!

Warm regards

Pamela Morrison IBCLC
Rustington, England




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