Guest guest Posted May 24, 2012 Report Share Posted May 24, 2012 I have one that has me a bit stumped. Permission to post from mother of course. G6P6 mom who breastfed first 3 kids 6-9 months. this baby is 3 weeks old. 4th,5th and 6th all had the same issue: " Very painful letdown deep in my breast tissue " describes as burning but not spasms. Lasts during entire feed but lessens. Then at the end of the feed she describes the nipple/areola as feeling irritated/itchy. She tried pumping before nursing this child just after birth and had the same reaction pumping. Her midwife recommended Diflucan for probable thrush. She has been on it two weeks. Mom does feel she has " internal yeast " and has modified her diet. Saw her for the first time today. Excellent anatomy on mom, shallow latch (corrected). Baby has a maxillary tongue tie but only a slight posterior tie. (Dad is a dentist and disagrees (lol). I saw absolutely no signs of thrush on mom or baby. Baby fed well, took 3 ounces on one breast and 1.5 ounces on the other. Wow, impressive,huh? My initial impression is that it could be the shallow latch BUT why would the pump have hurt too prior to her ever nursing the child? I also think it may be vasospasms from previous injury/possible thrush. It has been 4 years since her last child. She takes prenatals, probiotics, magnesium/calcium, B complex and diflucan. Mom is very sad, depleted. With 5 other kids and breastfeeding hurting at every feed, you can imagine her frustration. The deeper latch helped some but she was still hurting during the feed. I gave her a vasospasm care plan. I would love any feedback, I have this feeling I am missing something. Liz Pevytoe, RN, IBCLC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2012 Report Share Posted May 25, 2012 I have two thoughts.One is that some moms just have an anatomy/physiology that predisposes them to discomfort during feeding - they are the outliers on the normal curve of breastfeeding. They can try many things to relieve this - positioning, latch, warming or cooling the breasts - they are unusual, so there are not pat answers to their problems. The other is that she may need antibiotics, not diflucan. She may be predisposed to a kind of low-grade mastitis that causes pain, but not in the usual, focused way.Sharon Knorr, IBCLC, Colorado, USA I have one that has me a bit stumped. Permission to post from mother of course. G6P6 mom who breastfed first 3 kids 6-9 months. this baby is 3 weeks old. 4th,5th and 6th all had the same issue: " Very painful letdown deep in my breast tissue " describes as burning but not spasms. Lasts during entire feed but lessens. Then at the end of the feed she describes the nipple/areola as feeling irritated/itchy. She tried pumping before nursing this child just after birth and had the same reaction pumping. Her midwife recommended Diflucan for probable thrush. She has been on it two weeks. Mom does feel she has " internal yeast " and has modified her diet. Saw her for the first time today. Excellent anatomy on mom, shallow latch (corrected). Baby has a maxillary tongue tie but only a slight posterior tie. (Dad is a dentist and disagrees (lol). I saw absolutely no signs of thrush on mom or baby. Baby fed well, took 3 ounces on one breast and 1.5 ounces on the other. Wow, impressive,huh? My initial impression is that it could be the shallow latch BUT why would the pump have hurt too prior to her ever nursing the child? I also think it may be vasospasms from previous injury/possible thrush. It has been 4 years since her last child. She takes prenatals, probiotics, magnesium/calcium, B complex and diflucan. Mom is very sad, depleted. With 5 other kids and breastfeeding hurting at every feed, you can imagine her frustration. The deeper latch helped some but she was still hurting during the feed. I gave her a vasospasm care plan. I would love any feedback, I have this feeling I am missing something. Liz Pevytoe, RN, IBCLC Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2012 Report Share Posted May 25, 2012 Back to thinking about solutions for anatomy that is not going to be corrected by surgery. So....have your tried having mom lean back and really have baby face down, but head extended a bit? Like biological, but not the nipple feeding video that makes me cringe. Haha. More control from mom, like...a combo of Dr. Smilie cross cradle, kind of no head touching but mom has baby more angled than straight across and and leaning back. I know, hard to explain. But I find it helps some moms who tend to keep putting that one finger on the baby's head. And yes, poor mom! - Pam MazzellaDiBosco, IBCLC, RLCBirthing & Beyond, Inc.Labor Support and Lactation Consultant Services Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2012 Report Share Posted May 25, 2012 Thanks. She was started on antibiotics today. So that is one think. And I will try the positioning you mention, thanks. She and I are willing to try whatever. I am determined to help her figure this out. Liz Pevytoe, RN, IBCLC > > Back to thinking about solutions for anatomy that is not going to be > corrected by surgery. So....have your tried having mom lean back and > really have baby face down, but head extended a bit? Like biological, but > not the nipple feeding video that makes me cringe. Haha. More control from > mom, like...a combo of Dr. Smilie cross cradle, kind of no head touching > but mom has baby more angled than straight across and and leaning back. I > know, hard to explain. But I find it helps some moms who tend to keep > putting that one finger on the baby's head. And yes, poor mom! > > > > - > *Pam MazzellaDiBosco, IBCLC, RLC > Birthing & Beyond, Inc. > Labor Support and Lactation Consultant Services > * > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 25, 2012 Report Share Posted May 25, 2012 One suggestion that comes to mind is the possibility of Mammary Constriction Syndrome. I listened to a talk by Edith Kernerman at GOLD last year. She talked about another cause of breast pain that is worth considering is Thoracic Outlet Syndrome. And went on to describe exercises that might help. New Pectoral Muscle Massage to help with Mammary Constriction Syndrome 1. Mother uses her left hand to support her breast and her right hand to massage her upper pectoralis with a flat hand. 2. Mother uses her left hand to support breast and right hand to massage lower pectoralis with a flat hand 3. Mother uses her left hand to support breast and right hand to massage serratus with a flat hand. 4. Mother uses her right hand to support her breast and left hand to massage inner pectoralis with a flat hand or finger tips. The New Pectoral Muscle Doorway Stretches to help prevent the symptoms of Mammary Constriction Syndrome Stand upright in an open doorway then bend your elbows and rest your forearms vertically on the door frame. Without moving your forearm position, take a step forward and lean forward a little until you can feel the stretch in your chest. Hold for 20 to 30 seconds. The upper chest becomes more stretched with elbows lower and the lower chest and pectoralis minor become more stretched with elbow higher. Shoulder Blade Squeeze This exercise can be performed while sitting on a chair with your back held straight and both feet flat on the floor. Push your shoulders in a backward motion and squeeze your shoulder blades together until you feel tension. Release after 10 seconds. I like this because it costs nothing, is very easy for mother to do quickly, by herself, and without too much exertion. It can be used as a diagnostic tool for Mammary Constriction Syndrome. When this is the problem it causes immediate relief, is non invasive, non medical and non pharmaceutical. And it can be repeated as often as necessary without fear of “overdose”. And if it doesn't help, well at least we've done no harm. Edith Kernerman talk is still available from Health-e-learning at http://www.health-e-learning.com/courses/experts-in-lactation/224-xl34 and I believe she is still researching the topic for a paper later on. Best wishes, SARAH Hung IBCLC Flat 10D, Hoover Mansion, 10-16 Oaklands Path, Mid-levels, Hong Kong Tel: 2548-8202 or 9125-2343 www.lotuslactation.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted May 31, 2012 Report Share Posted May 31, 2012 I had a similar pain with my 3rd baby. Every feeding was a deep pain inside, through the feeding. He had a posterior tongue-tie, his head was a light to the left all the time and a dysfunctional suck. After everything was fixed. Breastfeeding was a blast. Sent from my iPad Quote Link to comment Share on other sites More sharing options...
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