Hi,
I need some help on this one.

Mum has 4 week-old baby, second child. Normal labour and delivery, no
interventions, no pain relief. First breastfeed soon after birth, left
side fine, right side painful. This has continued. The pain is in the 6
o'clock position under the right breast midway between the areola and
the chest wall. It is a very specific area, Mum can point to it
directly. She says the pain is as though the breast has been stitched
and the 2 ends of the thread are being pulled taut.
At the end of the feed the pain changes to a burning which goes on for
30 minutes. As the day goes on the after pains last longer until she is
in constant pain. She gets a little relief if she presses on the area.
By  the evening it is painful to lift her right arm.

I watched the baby feed and the latch is OK, he glugs and gets lots of
milk, MER is strong. Nothing to see on the breast, and nothing feels
abnormal on palpation.

Baby is thriving.

She had this with her first child and it spontaneously resolved at 10
weeks. She woke up one morning and the pain had gone.

She is at the end of her tether as the baby will only settle with
physical contact with someone. She has to constantly carry him in a
sling and sleep with him on her chest at night.  Dad is no help, but I
have suggested that she might negotiate some sleep time for herself and
let Dad sleep with baby on him.

Can this be thrush, as the pain is confined to such a small area in one
breast?

If not thrush - what else?

Mum may dry up that side and feed on one side only, but will wait to see
if anyone else has any ideas!

Thanks,


--
Carolyn Westcott RN IBCLC Southampton UK
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