A few weeks ago I posted regarding a mom who complained of increasing
back/leg pain directly linked to nipple stimulation via baby of pump.  The
pain specifically waxed and waned with the presences or absence of nipple
stimulation.

Thanks to all who replied, it was helpful.
Here is a summary of what I have found out.  The possible etiologies of the
increasing pain were:
!)  Confusing uterine pain with back pain.  Possible but not likely since the
pain traveled down her leg.
2) Oxytocin.  Could this increase pain by increasing blood flow to either the
area of the brain that receives pain messages or to her back?  Maybe. Hmmm.
Any ideas?
3) The breasts are innervated via the sympathetic nervous system.  Could
nipple stimulation (or sympathetic nervous system stimulation) possibly
augment the pain
pathways?  I spoke with a neurologist and he replied that most of the
evidence is showing that this is not a mediator of pain.  But, then he also
said that is was possible since we still do not really know that much about
how pain occurs.
4) Lastly, maybe the patient somehow began to associate the two and developed
a Pavlov's dog sort of response.

Clearly, whatever the cause, this woman's pain was not controlled leading to
failure to thrive in her infant and ultimately discontinuation of
breastfeeding.  How sad for both her and her infant to be robbed of the
benefits of breastfeeding by an inability to control her pain.  Only
ibuprofen was offered.

 I will forward the input from those Lacknetters who wrote about the pain
they also had as well as some of the insightful suggestions for controlling
her pain.  Thanks again and if anyone else has any info  to help explain this
phenomenon, please feel free to offer your input.

Christine Betzold  MSN,  RNP, CLE

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