Re: Odd case - need opinions

[Guest guest]

, I forgot about this! I had a mom years ago with this odd shooting pain that traveled from her breast to her arm and every time she nursed.  Zero nipple pain, happy well fed baby number 2.  I think this was maybe 18 years ago because I didn't have my twins yet. Haha.  I was at a conference and started asking to see if anyone had heard of it before. Mom had an MRI to be sure nothing was wrong, and nothing was ever found.  Eventually it just stopped.  I haven't heard of it happening since then.  I wonder if this would have helped her. 

-- Pam MazzellaDiBosco, IBCLC, RLCBirthing & Beyond, Inc.Labor Support and Lactation Consultant Services

[Guest guest]

You may also want to look into the research presently being done at Dr Jack Newman's clinic on the breast pain associated with muscle contracture. They have a handout ($) on it showing how to stretch and massage pectoral muscles to reestablish circulation and relieve pain.Edith Kernerman did an excellent presentation on the subject at Gold11. It is available on the expert lectures website from Health-e-learning.Ghislaine Reid, IBCLCMontréal, Québec, CanadaEnvoyé de mon iPadLe 2012-05-24 à 16:48, Sharon Knorr a écrit :

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

[Guest guest]

And for the dentist-father, you can refer them to dr Kotlow's excellent PPT on his website. A posterior TT can cause mechanical injuries to nipples leading to compression pain.Ghislaine Reid IBCLCMontreal, Quebec, CanadaEnvoyé de mon iPadLe 2012-05-24 à 16:48, Sharon Knorr a écrit :

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

[Guest guest]

Excellent suggestion! I find many mothers get a good relief from the biological nurturing position. Ghislaine Reid, IBCLCMontreal, Quebec,CanadaEnvoyé de mon iPadLe 2012-05-24 à 18:53, Pam MazzellaDiBosco a écrit :

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

[Guest guest]

Thanks so much, this is surely worth a try!

Liz Pevytoe, RN, IBCLC

>

> 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

> Lotus Lactation Logo Hung IBCLC

> Flat 10D, Hoover Mansion, 10-16 Oaklands Path, Mid-levels, Hong Kong

> Tel: 2548-8202 or 9125-2343

> www.lotuslactation.com <http://www.lotuslactation.com/>

>

[Guest guest]

I absolutely did give her Dr.Kotlows site. I LOVE it, it has changed the way I

practice and has improved my clients success rates many fold.

Liz Pevytoe, RN, IBCLC

> >

> > 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

> >

> >

> >

>

[Guest guest]

And Pam's remembering got me to thinking that maybe the mother would be helped by some chiropractic. Maybe there is a nerve that is being pinched that is affected more when there is more pressure from more milk.

Dee Kassing

, I forgot about this! I had a mom years ago with this odd shooting pain that traveled from her breast to her arm and every time she nursed. Zero nipple pain, happy well fed baby number 2. I think this was maybe 18 years ago because I didn't have my twins yet. Haha. I was at a conference and started asking to see if anyone had heard of it before. Mom had an MRI to be sure nothing was wrong, and nothing was ever found. Eventually it just stopped. I haven't heard of it happening since then. I wonder if this would have helped her. -- Pam MazzellaDiBosco, IBCLC, RLCBirthing & Beyond, Inc.Labor Support and Lactation Consultant Services

[Guest guest]

Well, I think the TT needs to be addressed. Maybe you can get dad to talk with

Larry. Or start by sending Larry some pics.

I would refer mom and babe for bodywork.

Then I would look into nutrition or supplements--mag, iodine, vit D,

L-arginine--depending oh the rest of the story.

I would not have suggested abx--I am amazed at how flagrant we are as a

profession about damaging the gut.

Tow, IBCLC, CT/USA & Paris, France

>

> 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

>