Hello world!

I signed up to Lactnet recently and have been listening in with interest for the past three weeks. I am a Breastfeeding Counsellor with the National Childbirth Trust in Bedford - a town just north of London. I am hoping that the wealth of experience out there will help a woman who came to me last week: she had her 4th child a week ago and is suffering with the same breast pain that she has had with each of the others. The pain starts at the beginning of a feed and lasts for an hour plus afterwards. She describes it as 'tugging along the lines of the ducts'. 

My immediate thoughts were that it must be thrush or incorrect attachment. However, she has been using anti-fungal cream on the nipples for 4 days without any change and there are no signs of thrush either with her or the baby. Mother is reluctant to take a systemic treatment unless this is the only possible cause left. With her second baby she did have thrush (with the typical white spots in baby's mouth). This cleared up with anti-fungal treatment and her breast pain subsided - this was at about 6 weeks.

4th time around this mother has been particularly careful with positioning and attaching her baby. She is aware that with the others this has not been perfect, resulting in nipple trauma. This time there has been no nipple trauma and when I observed her feed, I was only able to make minor adjustments so the initial latch was more comfortable. However, the pain during and after the feed was still there, in spite of (what I considered to be!) spot-on positioning.

Before you all yell "Candida" back at me, should I consider her history? The breast pain with each of her 3 previous babies has subsided at around 6 weeks, for no apparent reason, other than the one with obvious thrush. The date '6 weeks' makes me wonder about the link with prolactin levels. I notice in the archives that this has been mentioned before - does this sound like a possible case and if so, what can she do to make the next few weeks more comfortable? The woman's midwife has also suggested a pain relieving drug with anti-inflammatory action. She is not engorged - in fact her breasts are large and soft, but has anyone heard of any evidence that anti-inflammatories can help with unexplained breast pain?

Regards from a grey-skied England,

Helen Marlow
Breastfeeding Counsellor, National Childbirth Trust