I received a call from a mother tonight who has a history of breast
pain and disfuntion during breastfeeding.  She has breastfed 3
children ages 11,3 and 1. The baby is still nursing.  With each
pregnancy, she was initially engorged in both breasts, but totally
stopped making milk in her left breast at 4 weeks.  With her first
baby she was so lopsided and self concious that she weaned at 7 weeks.
  With baby 2 she pumped for several months trying to keep up
production on that side.  She had mastitis twice during that time.
She ended up nursing on one side only for 14 months. With this thrid
baby, she was fine for 4 weeks and lost her milk again, switched to
one side  and didn't worry.  Baby is big, 30 pounds at a year.
However, that breast has been very tender to the touch. She is in an
HMO and has been seen by 2 OBs, they don't feel anything and have
dismissed her concerns.  They are unwilling to do an ultrasound and
say she is too young for a mammogram (33). She says she "comes off
the table" from the pain when she is examined. She can still express
some milk from that side and says it is very thick and oily. She has
not nursed on that side in over a year. I suggested she go outside
her HMO and pay for a second opinion.  She is concerned and feels
that the pain means "something is wrong". In talking with her, she
reported pumping to try and relieve the pain (if due to a plug),
massage, touching it a lot.  I wonder if she is not keeping up some
sort of inflammation in her attempts to make it better?  She also
reported being sexually abused at age 13 and reported that the man
touched her left breast and she has wondered if there is not some
sort of psychological basis for her problems. Does anyone have any
ideas or suggestions for her?  Thanks, Cathy Liles