This is neuropathic pain.  It is caused by irritation/inflammation/injury/invasion to a nerve along its course (instead of from the nerve ending).   It could be that that breast had some damage or infection, which healed but there may be residual inflammation or even scarring that causes the pain.





At Hospice (my day job), we treat this with a drug like carbamazine, amitriptaline, gabapentin, pregabalin, or prednisone.  But we aren’t worried about a baby or even long term future; only about relieving pain immediately.  





So I think I’d try intensive thrush treatment; if local meds like nystatin didn’t work, I give fluconazole.  That usually works (perhaps candida affects nerves? I am not sure.  I use it because it worked well when we thought all of these pains were caused by thrush)  



Nan





Dr NE Jolly  MB BCh IBCLC  LLLL



Port Elizabeth



South Africa













Sent from Windows Mail















Date:    Thu, 27 Mar 2014 19:57:33 -0400

From:    "Dana Schmidt, RN, IBCLC" <[log in to unmask]>

Subject: Stabbing pain with weaning



PTP.  Mom of a nearly 2 year old that only nurses at night with complaint of  "stabbing-like pain through the nipple." She denies feeling any plugs, hotness, redness or any other signs or symptoms of mastitis.  No blebs and says it does not feel like vasospasms.  It can happen during nursing or throughout the day. Thoughts?



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