PTP:

Saw a 32 day old dyad.  Mother states that during the first 6 days postpartum her milk was plentiful and she pumped for comfort, obtaining ~ 5 ounces per pump session.  Around the 6th day PP, it was determined that she had retained placental fragments and she had "surgery", then developed an infection.  MOB has since recovered.  For the past few weeks, MOB describes that around 6:00 pm and throughout the rest of the evening she experiences sharp, stabbing pain deep in her right breast. 

She attributes this pain to her breast being empty as evidenced by the infant crying for long periods during this time period and not being satisfied with breastfeeding alone (she has been giving 1-2 bottle of formula for the past few days during this period).  The pain is moderately relieved by using ice packs to the breast until she falls asleep.  When she wakes up, the pain is gone. Breast exam is benign. 
	
MOB has been told she has postpartum depression and has been prescribed Zoloft.  She has not taken the medication because she was worried about breastfeeding.


Can anyone provide possible causes/interventions/direction for me to provide to this mom?


Thanks!

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