Last month I posted about a mother with stabbing pains in her breast that sounded as though it could be thrush, but was denied by all the health professionals she visited.  Many of you made suggestions which I passed on to her.

I have now heard from the mother with a complete history.  The good news is that the problem has been resolved and it doesn¹t seem to have been either thrush or Reynaud¹s, the two most likely explanations suggested by Lactnetters.  She has asked me to tell you about it.  Here is her story:

³I started having deep pain in one breast when my baby was 3 weeks old.  The initial breastfeeding had gone very well and I had a big and strong baby.  The pain always started approx. 5 min. after each feed and it felt like I was being stabbed--and the knife turned.  It would last about 1 hour.  Aspirin (or any other painkiller) would relieve the pain.

I went to see the breastfeeding counsellor at one hospital.  She said it was probably an inflammation and I should take an anti-inflammatory such as aspirin.  It was due to bad attachment and I should do it Œher way¹.  That was not very helpful as my son was too heavy for Œher way¹ (a drawing is included which wouldn¹t be what I would suggest or most other British breastfeeding counsellors).  She didn¹t look how I was doing it and I came away quite frustrated.

The first doctor¹s visit.  He diagnosed mastitis without really pausing to look, just judging by the pain.  One week of antibiotics--no change.

Second doctor¹s visit.  She didn¹t really know what to diagnose.  She noticed the breasts and nipples were quite bruised.  She thought it was inflamed and prescribed aspirin.  She didn¹t think it was thrush.  She referred me to a breast specialist at another hospital that very day, to see if he could come up with any answers.

Hospital.  An ultra-sound of the breast did not reveal any hidden blockages (that was one assumption as I had some scar tissue near the nipple from an operation in puberty).  The doctor did not really know either.  He prescribed a different pain-killer and said to try an anti-spasmic drug.  I took both once, with no result.  He also recommended to visit the breastfeeding counsellor of (another) hospital.  He also excluded thrush.

Visit to a Naturopath (as conventional medicine dismissed thrush each time, but your literature seemed plausible) but she also excluded it:  no symptoms, no history.

My last stop was the breastfeeding counsellor of--Hospital.  She was the first person who had come across the symptoms before.  It was an inflammation of the nerves due to bad attachment.  Also the advice given often, and which I was following religiously, to only offer one breast per feed was wrong and very harmful.  As I was feeding nearly an hour, the strain was too big.

3 to 4 weeks after the birth, the breast apparently changes shape:  it goes from very full to more flaccid, softer.  So my son had attached well to start with, but had formed a bad habit when the breast changed and had started taking only the tip.  In retrospect, I also realise that I wasn¹t concentrating enough, but doing all sorts of things by the side (telephoning, reading, eating, etc.)

This advice apparently had its origins from some research done in Wales on underweight babies and it was observed that some would do better if only offered one breast.  The result of this research was then taken out of context and used as a guideline for all babies.  I must say I am very angry at having been taught this in my ante-natal breast feeding classes.

It was relatively easy to re-educate my baby.  Within two days he was taking the whole aureole and the very sharp pain disappeared.  It took another two to three weeks for the breast to heal completely.

I am now feeding every 3 hours and each breast for max. 15 minutes and it suits us fine.²

I¹ve written to the mother apologising for not asking the right questions as I should have picked up that there could have been problems with the attachment and thanking her for increasing my knowledge.  I also included some information about ³finish the first breast first² and some babies won¹t want the second side.  I had never heard of ³inflammation of the nerves due to bad attachment² before, though.  How likely is this to be the explanation of her pain?  Obviously improving the attachment and changing the management has worked for this mother.  Are we so used to seeing thrush when there are stabbing pains in the breast that we are missing nerve inflammation? or is it something unusual?

Jill Dye, LLLleader, England  where the weather seems cold, but the sun is shining and there is no rain or snow.

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