I am posting this case on behalf of a Public Health Nurse/IBCLC who does not
have access to Lactnet.  She was out to see a mother of a 9 day old infant.
Infant is thriving (breastfeeding well - not fussy) but mother is
experiencing deep, burning breast pain and intense itching over the surface
skin of both breasts, ONLY when the baby is nursing.  It starts several
minutes after the baby has begun nursing.  Mom has an 11 yr. old who only
nursed for 3 weeks - mom stopped because of intense pain.  Mother descibes
the pain as 6-7 on a scale of 10.  States she has always had intense pain in
breasts when exposed to cold - "hurting terribly".  PHN observed
breastfeeding and noted compression line across nipple but mother describes
no nipple pain at all - nipples intact and no nipple blanching noted.  PHN
said positioning and latch on correct.  PHN also noted that mom flushes very
easily - skin over chest and neck, red and blotchy during nursing.  No
apparent signs of thrush in infant.  No antibiotic use in either mom or babe
although mom did have a vaginal yeast infection one mo. prior to delivery -
not treated as symptoms resolved.  Because of Hx of breast pain with
exposure to cold and no nipple pain, PHN is not convinced about possibility
of thrush involvement and is wondering if the pain could be vascular in
origin.  If so, how would this be managed?  Looking forward to your input.
Since I will not be checking Lactnet Digests for awhile, please email me
directly.  Season's Greetings to All!  Shirley Phillips,RN, IBCLC, Winnipeg
Breastfeeding Clinic.