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Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 3 Apr 2001 17:46:30 -0400
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I am turning to the wise minds of lactnet for help with this situation.
Mom came to me at the WIC office with severe pain in her breasts.
Described it like
shards of glass inside.  Baby 4do.  Vaginal birth.  Mom is a group B
strep carrier and
was treated with antibiotics prior to birth.  Has hx of vaginal yeast
infections.  So okay
I suspect this is thrush.  Mom says pain is too great to put baby to
breast but is willing
to try an electric pump (huh?) to keep her supply up while she deals with
the pain.  Agrees
to pump 8-10 times/day or breastfeed if she can tolerate it.
Mom goes to OB gets 5 days of Diflucan.  Two days later she is feeling
much better.
Calls me (on a friday), I set up a plan to get baby back on breast.
Suggest she stop pumping and only nurse over the weekend and to come for
a wt check on Monday, call me if things aren't going well (ie: mom or
baby frustrated, any pain etc).  Comes in on Monday and tells me she
could only "stand it" until 4pm on Saturday and 2pm on Sunday.  Used ABM
or expressed milk in bottle in the afternoons and evenings.  Has only
been expressing < 1oz each time (using double pump lactina).  Pain is
returning.
No sign in baby of thrush (mouth, diaper area, not fussy).  Describes
pain as similar to first time but not as severe.  I suspect not long
enough TX with Diflucan, ask her to return to OB for another course.
Baby hasn't gained any weight in 1 week (in fact lost 1oz).  I'm
concerned about her milk supply and origin of pain and baby's lack of wt
gain.  Mom is visibly distressed.  I ask her what SHE wants to do.  She
decides she will pump as often as she can, not put the baby to breast
until she can deal with the pain again.  Called this am: has gotten
another 5 days of Diflucan from OB plus a once a month pill.  Nursed baby
at breast last on 4/2. Says she can hear baby swallow at breast. Is
pumping only 3-4 times/day, knows this is not optimal but can't deal with
pain.  Is using fenugreek as well.  Only gets <1oz per session (same as
when she was pumping 8-10 times) and is discouraged.  Breastfeeding
remains painful (shooting pains) before, during and after nursing!  Any
ideas what else could be going on here?
P.S. I have never been able to see the baby at breast.  Was zonked out
the one time I had them both in the office.  I can't spend that much time
with them when they are there so we couldn't wake the baby up enough to
breastfeed in the time that I had with her.  She does state though that
he accepts the breast willingly and is not usually very sleepy.
I'm a little bit embarrassed to post this because I feel I should be able
to figure this out but I can't. :-(

Thanks,
Ilene Fabisch, IBCLC
Brockton, MA

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