Hello All:

I'm hoping to pick some of your intelligent brains here.  I got a call from a
nurse in a pediatric practice today about a mom that is having incredible
sharp, shooting pains in her breasts about 10-15 minutes after breastfeeding.
 Has been since almost since the beginning (baby is now 2 months old).
 Breastfeeding has been observed by a couple of LC's who find no fault with
positioning.  Nipple basically looks the same after feeding as before
feedings.  MOm has tried pumping before BF to start milk flow, without any
difference.  Mom does not have pain after pumping.  Many different BF
positions have been tried without any change in pain.  My first thought was
ductal yeast and mom was treated with 150mg Diflucan once/day for 3 days with
relief for 2 days after that, then pain returned (which suggests to me this
might be the problem).  Baby was also treated, but I do not know with what or
for how long--neither baby nor mom have shown any overt symptoms of thrush.
Mom has never had vaginal yeast infections, has not been on antibiotics.  Mom
apparently had one episode of frank blood on one breast only during a
pumping--this has not been repeated.  Breast exam was done, no
lumps/abnormalities found.  Baby is gaining weight appropriately.  So wise
ones, what's happening here?  The RN specifically wanted to know what how
long/how much can Diflucan be given as she too thinks this is the real
problem.  If this is so, how should baby be treated?  Are there other/better
treatments for mom if indeed this is ductal yeast?  What are the other
possibilities for the cause of this situation?  This poor mom wants to
continue to breastfeed but is about at the end of her rope.  I have not seen
her myself, so all this info is second hand.

Secondly, can anyone give me some good references/resources on hyperlactation
and overactive letdown.

I'm way behind in reading, so if these things have been discussed recently,
pardon me.  Thanks!

Theresa Chambliss, RN, CLE