Thought I'd see if any of you wise folks out there have any other possibilities
for this woman's pain.  She called me two days ago when she was 6 days
postpartum complaining of *incredible* burning pain in her breasts.  Says it
goes from the nipple deep into the breast.  She described the pain as constant
although worse during suckling, not associated particularly with MER, no
blanching of the nipple, no nipple damage except for small blisters, no
engorgement.  She saw no signs of thrush in baby's mouth, she has had vaginal
yeast infections but not recently, antibiotics in her IV after c-sec, and a
10-day course of antibiotics during the pregnancy.  Didn't know what it could be
but yeast, so asked doctor for fluconazole for her and suggested clotrimazole
cream also.

She was on the phone again first thing this morning, said the pain was no
better, worse if anything, felt the "infection was moving down" as she was now
having burning with urination, and felt like she had absolutely no energy.  No
fever.  She had rented a hospital-grade pump to see if that would lessen the
pain but it had been ineffective--she was only able to get about an ounce out of
full breasts.  Had her stop in to see me this afternoon on her way to her MD.
Just as she had told me, her breasts looked and felt completely normal, no
nipple damage, etc.  I suggested she start taking ibuprofen to help deal with
the pain and presumed inflammation and hope that the fluconazole would kick in
in another day or so.  Don't know if her MD came up with any other
possibilities, I talked to him before he saw her but not after.

This is a mom who was quite motivated to breastfeed but doesn't know how long
she can bear the pain.  She breastfed her first child who is now 11, this is a
long-awaited second child after many years of trying.  Can any of you think of
anything besides yeast that could cause this pain?

Becky Krumwiede, RN, IBCLC
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