Re: Sudden Onset Breast Pain???

May 24, 2012

I would suggest she ask for an antibiotic. It sounds to me like an infection, especially since she did not empty the breasts well on the day she travelled. Of course, you can get an infection for absolutely no reason at all. Also sounds to me like doctor has no idea, since he told her to wait two days, then told her to wait two more!

Another idea: She is taking goats rue, which builds ductwork in the breast. She also states that her breasts are twice the size they used to be. Could it be that the ductwork is being built and preparing to make milk, but her bra is too small now?

Dee Kassing

Subject: Sudden Onset Breast Pain???To: Date: Wednesday, May 23, 2012, 10:59 PM

Need your help wise ones.... Permission to post of course

29 y.o. mom, hx of luteal phase defect, PCOS, infertility, gastric sleeve, depression, anxiety, ADHD, induced difficult vag birth. Minor breast changes in pregnancy.

Baby had seizures on day 2, in NICU for 7days, was NPO at first then formula fed, now getting both formula and Bm. No reason was ever found for seizures. Baby is on phenobarbitol. Oral exam normal except for strong suction. Visually baby appears completely normal.

Prior to seeing me in late Feb, mom had taken fenugreek, Reglan and power pumped but after poor start and w/ hormonal hx, still was not getting good results. After seeing me, went back on Metformin, started taking goat's rue and domperidone (no more reglan!). Also started a much more rigorous pumping schedule with different pump flanges in addition to putting baby to breast regularly. Paced bottlefeeding and lots of work on latch.

3 weeks after starting new plan, breasts had become more full and she had doubled her output but still was not making enough to wean from formula (with both test weights and pumping, mom hovers at about 1.2-1.3oz total per feeding).

At that point (mid-March), she said her breasts, "ache on and off that I can only assume is growing pains that you normally get during pregnancy when your breasts are developing" She described the pain as very mild and intermittent. No other S/S.

She called me a couple of days ago, stating she had sudden onset breast pain on Friday. Hurts less when pumping then feeding. I have questioned her about latch changes, teething, baby illness, yeast symptoms, plugged duct symptoms. Mom says no external signs of trauma, no redness, bruising, nipple wounds, blanching, etc. This is her story...

I'm having an issue. It suddenly started hurting when I'm breastfeeding my daughter. I went to the dr and they sent me home and said call back in 2 days if it's still happening. On friday we were in the car all day, Rowan didn't want to eat in the car very well, my breasts weren't very emptied, I forgot to bring the breast pump. It felt slightly uncomfortable like when your just a bit full.Friday evening we got into the hotel. I fed her as much as I could, expressed as much as I could, got in the hot tub at the hotel and then tried to breastfeed, and they got much more empty.Both were hurting my left more (but it creates more milk)We got home Sunday night I started using that nipple ointment and it helped a bit I think. Went to dr 9:40am Tuesday. suppose to call back in 2 days if no change. nurse

practitioner did not think it was yeast, but thought it was a duct problem. if it doesn't feel better in 2 days, suppose to have an ultra sound to see what's going on.So the pain. It hurts when they are full of milk. The smaller the amount of milk in them, the less they hurt when you touch them. When you touch them, the nipple does not hurt it hurts inside somewhere, behind the nipple.When I am feeding Rowan, it hurts when she first starts, then toward the end, not as much, as soon as she stops, pain is gone. But it hurts REALLY bad when she first starts. Not crying bad, but where you might set your jaw and struggle through until the pain lets up. Which usually doesn't take a really long time.If I pump, it doesn't hurt very much, maybe I can feel a little pinch or so inside, but nothing I think isn't ordinary.The pain feels like... deep inside. where you can "feel" the let down. When your really full and it starts getting

empty it kinda feels good, but if you made that feeling more intense it would hurt. That's the kind of hurt it is.So, what I am doing now pumping or feeding her very often, trying to use heat to relax the breast tissue to help with the letdown, and using that nipple ointment the dr office gave me a while back.Suggestions, ideas? Any idea what this might be or what to look for?

Can your let down reflex suddenly become extremely painful due to the goats rue or the domperidone raising your prolactin levels?I'm sitting here going to power pump, just pumped to empty my breast and waiting my 10 min or so before going a bit longer and I'm feeling in my left side what almost feels like my breast filling up again or releasing some milk like let down reflex so it can fill up better. The only other question I have is can something mildly irritate the ducts inside. Just enough I can feel it since my let down reflex is pretty strong, just I never considered it painful. Perhaps a mild irritation is just making me feel it worse.

She just told me tonight that she feels like her breasts have at least doubled in size since I saw her (still at 1.2oz/pump or feed though). She also just disclosed tonight that she is taking Vyvanse (L3) as well as more milk plus with goat's rue, extra fenugreek, metoformin, probiotics, domperidone 60mg divided into 3 doses/24 hr, and the mini pill (month 3 of this). She is on so much stuff and is such a complex case that I have no clue what could be causing her breast pain. Yikes!

Any ideas would be appreciated. Thanks so much!

Carroll

May 24, 2012

,My first thought is that she may be wearing a bra that is tight or just that she is wearing a bra too long. It is a simple idea but at least worth looking into.There are so many things going on with this mom. Keep us posted.Leigh Anne O'Connor, IBCLCSent from my Verizon Wireless BlackBerrySender: Date: Thu, 24 May 2012 03:59:47 -0000To: < >ReplyTo: Subject: Sudden Onset Breast Pain??? Need your help wise ones.... Permission to post of course29 y.o. mom, hx of luteal phase defect, PCOS, infertility, gastric sleeve, depression, anxiety, ADHD, induced difficult vag birth. Minor breast changes in pregnancy.Baby had seizures on day 2, in NICU for 7days, was NPO at first then formula fed, now getting both formula and Bm. No reason was ever found for seizures. Baby is on phenobarbitol. Oral exam normal except for strong suction. Visually baby appears completely normal. Prior to seeing me in late Feb, mom had taken fenugreek, Reglan and power pumped but after poor start and w/ hormonal hx, still was not getting good results. After seeing me, went back on Metformin, started taking goat's rue and domperidone (no more reglan!). Also started a much more rigorous pumping schedule with different pump flanges in addition to putting baby to breast regularly. Paced bottlefeeding and lots of work on latch.3 weeks after starting new plan, breasts had become more full and she had doubled her output but still was not making enough to wean from formula (with both test weights and pumping, mom hovers at about 1.2-1.3oz total per feeding). At that point (mid-March), she said her breasts, "ache on and off that I can only assume is growing pains that you normally get during pregnancy when your breasts are developing" She described the pain as very mild and intermittent. No other S/S.She called me a couple of days ago, stating she had sudden onset breast pain on Friday. Hurts less when pumping then feeding. I have questioned her about latch changes, teething, baby illness, yeast symptoms, plugged duct symptoms. Mom says no external signs of trauma, no redness, bruising, nipple wounds, blanching, etc. This is her story...I'm having an issue. It suddenly started hurting when I'm breastfeeding my daughter. I went to the dr and they sent me home and said call back in 2 days if it's still happening. On friday we were in the car all day, Rowan didn't want to eat in the car very well, my breasts weren't very emptied, I forgot to bring the breast pump. It felt slightly uncomfortable like when your just a bit full.Friday evening we got into the hotel. I fed her as much as I could, expressed as much as I could, got in the hot tub at the hotel and then tried to breastfeed, and they got much more empty.Both were hurting my left more (but it creates more milk)We got home Sunday night I started using that nipple ointment and it helped a bit I think. Went to dr 9:40am Tuesday. suppose to call back in 2 days if no change. nurse practitio!ner did not think it was yeast, but thought it was a duct problem. if it doesn't feel better in 2 days, suppose to have an ultra sound to see what's going on.So the pain. It hurts when they are full of milk. The smaller the amount of milk in them, the less they hurt when you touch them. When you touch them, the nipple does not hurt it hurts inside somewhere, behind the nipple.When I am feeding Rowan, it hurts when she first starts, then toward the end, not as much, as soon as she stops, pain is gone. But it hurts REALLY bad when she first starts. Not crying bad, but where you might set your jaw and struggle through until the pain lets up. Which usually doesn't take a really long time.If I pump, it doesn't hurt very much, maybe I can feel a little pinch or so inside, but nothing I think isn't ordinary.The pain feels like... deep inside. where you can "feel" the let down. When your really full and it starts getting empty it kinda feels good, but!if you made that feeling more intense it would hurt. That's the kind of hurt it is.So, what I am doing now pumping or feeding her very often, trying to use heat to relax the breast tissue to help with the letdown, and using that nipple ointment the dr office gave me a while back.Suggestions, ideas? Any idea what this might be or what to look for?Can your let down reflex suddenly become extremely painful due to the goats rue or the domperidone raising your prolactin levels?I'm sitting here going to power pump, just pumped to empty my breast and waiting my 10 min or so before going a bit longer and I'm feeling in my left side what almost feels like my breast filling up again or releasing some milk like let down reflex so it can fill up better. The only other question I have is can something mildly irritate the ducts inside. Just enough I can feel it since my let down reflex is pretty strong, just I never considered it painful. Perhaps a mild irritation is just making me feel it worse.She just told me tonight that she feels like her breasts have at least doubled in size since I saw her (still at 1.2oz/pump or feed though). She also just disclosed tonight that she is taking Vyvanse (L3) as well as more milk plus with goat's rue, extra fenugreek, metoformin, probiotics, domperidone 60mg divided into 3 doses/24 hr, and the mini pill (month 3 of this). She is on so much stuff and is such a complex case that I have no clue what could be causing her breast pain. Yikes!Any ideas would be appreciated. Thanks so much! Carroll

May 24, 2012

My letdown when full is *always* painful. The emptier I am (was) the less it would hurt. By the time I got to 3-4 mo and my breasts were more supply and demand instead of trying to stay full all the time, it wasn't painful unless I missed a feed for some reason. But I could always stand still, not feeding, and know how full I was just by how my breasts felt, even untouched. Touching would be very uncomfortable. So it might be worth clarifying more with mom before assuming this is pathological, especially given that it sounds like she is making ductwork like gangbusters.

Lynn in MO

May 24, 2012

,

Holistically, she could try Natural Calm magnesium which would relax the muscle cells and reduce the pain of letdown. Inflammatone is a natural antiinflammatory she also could take. Any possibility of yeast overgrowth? Is she eating lots of sugar, carbs? Does she take DHA, vit D? These are things I'd explore with her after addressing structural issues, like the very simple bra size, infant suck, frequency of feeds, etc. You don't say how old the baby is but my guess was 4 mos or so since you mentioned teething. Perhaps, if you and she suspect dietary issues, a naturopath could help.

Barbara Latterner

May 24, 2012

My first thought is that she has a residual bleb/plugged duct right behind the nipple that is teetering on an infection. A bleb is very painful when baby is latched especially at the start, but many moms don't notice it when pumping. The duct is probably mostly clearing, but the bleb is causing a slight jam, so it never completely clears. It hurts more when she's really full because there's more milk pushing on the blocked up tissue. It probably started the day she didn't drain the breasts well. I've had a lot of success treating similar issues with caster oil compresses and heat and then also homeopathic phytolacca to prevent full blown infection. Good luck! Keep us posted if you figure it out.Deirdre Cannon, IBCLC, LLLFor Babies' Sake www.forbabiessake.comOn May 23, 2012, at 10:59 PM, "sandbc1a" wrote:

Need your help wise ones.... Permission to post of course

29 y.o. mom, hx of luteal phase defect, PCOS, infertility, gastric sleeve, depression, anxiety, ADHD, induced difficult vag birth. Minor breast changes in pregnancy.

Baby had seizures on day 2, in NICU for 7days, was NPO at first then formula fed, now getting both formula and Bm. No reason was ever found for seizures. Baby is on phenobarbitol. Oral exam normal except for strong suction. Visually baby appears completely normal.

Prior to seeing me in late Feb, mom had taken fenugreek, Reglan and power pumped but after poor start and w/ hormonal hx, still was not getting good results. After seeing me, went back on Metformin, started taking goat's rue and domperidone (no more reglan!). Also started a much more rigorous pumping schedule with different pump flanges in addition to putting baby to breast regularly. Paced bottlefeeding and lots of work on latch.

3 weeks after starting new plan, breasts had become more full and she had doubled her output but still was not making enough to wean from formula (with both test weights and pumping, mom hovers at about 1.2-1.3oz total per feeding).

At that point (mid-March), she said her breasts, "ache on and off that I can only assume is growing pains that you normally get during pregnancy when your breasts are developing" She described the pain as very mild and intermittent. No other S/S.

She called me a couple of days ago, stating she had sudden onset breast pain on Friday. Hurts less when pumping then feeding. I have questioned her about latch changes, teething, baby illness, yeast symptoms, plugged duct symptoms. Mom says no external signs of trauma, no redness, bruising, nipple wounds, blanching, etc. This is her story...

I'm having an issue. It suddenly started hurting when I'm breastfeeding my daughter. I went to the dr and they sent me home and said call back in 2 days if it's still happening. On friday we were in the car all day, Rowan didn't want to eat in the car very well, my breasts weren't very emptied, I forgot to bring the breast pump. It felt slightly uncomfortable like when your just a bit full.Friday evening we got into the hotel. I fed her as much as I could, expressed as much as I could, got in the hot tub at the hotel and then tried to breastfeed, and they got much more empty.Both were hurting my left more (but it creates more milk)We got home Sunday night I started using that nipple ointment and it helped a bit I think. Went to dr 9:40am Tuesday. suppose to call back in 2 days if no change. nurse practitioner did not think it was yeast, but thought it was a duct problem. if it doesn't feel better in 2 days, suppose to have an ultra sound to see what's going on.So the pain. It hurts when they are full of milk. The smaller the amount of milk in them, the less they hurt when you touch them. When you touch them, the nipple does not hurt it hurts inside somewhere, behind the nipple.When I am feeding Rowan, it hurts when she first starts, then toward the end, not as much, as soon as she stops, pain is gone. But it hurts REALLY bad when she first starts. Not crying bad, but where you might set your jaw and struggle through until the pain lets up. Which usually doesn't take a really long time.If I pump, it doesn't hurt very much, maybe I can feel a little pinch or so inside, but nothing I think isn't ordinary.The pain feels like... deep inside. where you can "feel" the let down. When your really full and it starts getting empty it kinda feels good, but if you made that feeling more intense it would hurt. That's the kind of hurt it is.So, what I am doing now pumping or feeding her very often, trying to use heat to relax the breast tissue to help with the letdown, and using that nipple ointment the dr office gave me a while back.Suggestions, ideas? Any idea what this might be or what to look for?

Can your let down reflex suddenly become extremely painful due to the goats rue or the domperidone raising your prolactin levels?I'm sitting here going to power pump, just pumped to empty my breast and waiting my 10 min or so before going a bit longer and I'm feeling in my left side what almost feels like my breast filling up again or releasing some milk like let down reflex so it can fill up better. The only other question I have is can something mildly irritate the ducts inside. Just enough I can feel it since my let down reflex is pretty strong, just I never considered it painful. Perhaps a mild irritation is just making me feel it worse.

She just told me tonight that she feels like her breasts have at least doubled in size since I saw her (still at 1.2oz/pump or feed though). She also just disclosed tonight that she is taking Vyvanse (L3) as well as more milk plus with goat's rue, extra fenugreek, metoformin, probiotics, domperidone 60mg divided into 3 doses/24 hr, and the mini pill (month 3 of this). She is on so much stuff and is such a complex case that I have no clue what could be causing her breast pain. Yikes!

Any ideas would be appreciated. Thanks so much!

Carroll

May 24, 2012

Wow Breda – a complicated case indeed. I second Dee’s suggestion with a twist – ask Doc to culture milk to rule out infection. Another thought: STOP the Goat’s Rue. If her breasts are growing and her supply is increasing – and even if the supply is not increasing – maybe she needs to back off Goat’s Rue and let her body take over. It almost sounds like the cocktail she is on triggered her body to start functioning better on its own too… Another thought: anti-inflammatory ‘stuff’. Suggest she eat foods or take a supplement that has an anti-inflammatory effect. She could take ibuprofen as well for a couple days and see if that eases things up. And, sometimes when my moms are having lots of breasts stuff I have them switch from all the warm compresses to only cold. 9 times out of 10 it works like a charm (for plugs, mastitis and engorgement). If the inside of the breast is working overtime and is infleamed or irritated, the last thing she wants is heat… Yes please keep us updated!Warmly,Jaye Jaye Simpson, CLE, IBCLC, CIIM, MoMBreastfeeding Networkwww.breastfeedingnetwork.net

May 24, 2012

the mini pill could be adversely affecting her supply. for sure! Beebe, M.Ed., RLC, IBCLC Lactation Consultant/Postpartum Doula www.second9months.comwww.facebook.com/thesecond9months--- Subject:

Sudden Onset Breast Pain???To: Date: Wednesday, May 23, 2012, 8:59 PM