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Re: deep breast pain

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Don't have time for a long reply, but this could be a type of neuralgia, a pain that lingers after an insult to the tissues and nerves even after everything seems to have healed. It can be seen in any part of the body, or even in parts that no longer exist, such as an amputated arm or leg. If it is not infection, perhaps she needs to see a pain specialist - there are many strategies that can be used to deal with this type of situation.

 

Sharon Knorr

 

So, in the new BAMS, there are some studies about how deep breast pain between feedings in unlikely to be candida as was thought.  My client had nipple damage on one side and is (still pumping and supplementing post frenotomy) and is experiencing sharp pains after feeding in the one breast.    I'm thinking vasospasm, but mom has no blanching or color change.  No shiny or flaky skin.  Nipple damage healed, but latch still uncomfortable on that side.  Could be bacterial infection, but seems unlikely if nipple is healed (and no sign of infection).

Thoughts?-- Eden, BA, IBCLC, RLCLactation ConsultantAtlanta Breastfeeding Consultants, LLCwww.AtlantaBreastfeedingConsultants.com

(404)-590-MILK (6455)

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Since nursing is still uncomfortable on that side, I'm leaning to the idea that baby is still damaging the nipple, just not to the point of tearing holes in it, and compressing or otherwise damaging the nerve that is then reacting by causing pain.

Dee Kassing

So, in the new BAMS, there are some studies about how deep breast pain between feedings in unlikely to be candida as was thought. My client had nipple damage on one side and is (still pumping and supplementing post frenotomy) and is experiencing sharp pains after feeding in the one breast. I'm thinking vasospasm, but mom has no blanching or color change. No shiny or flaky skin. Nipple damage healed, but latch still uncomfortable on that side. Could be bacterial infection, but seems unlikely if nipple is healed (and no sign of infection).Thoughts?-- Eden, BA, IBCLC, RLCLactation ConsultantAtlanta Breastfeeding Consultants, LLCwww.AtlantaBreastfeedingConsultants.com(404)-590-MILK (6455)

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At Gold this year, there was a talk about a compression of nerves that mimics

vasospasm. I haven't seen any publications yet, but they treated by pectoral

exercises. Very interesting!

The talk was by Edith Kernerman and was entitled " Mammary Constriction syndrome.

I would be glad to send the handout from the talk that I downloaded to anyone,

but don't know if that is allowed. I don't feel comfortable posting it here.

Thanks!

Tricia ELbl

IBCLC hopeful! Just 3 weeks left to wait...

LLL of Roselle/Schaumburg IL

 

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> So, in the new BAMS, there are some studies about how deep breast pain between

feedings in unlikely to be candida as was thought.  My client had nipple damage

on one side and is (still pumping and supplementing post frenotomy) and is

experiencing sharp pains after feeding in the one breast.    I'm thinking

vasospasm, but mom has no blanching or color change.  No shiny or flaky skin. 

Nipple damage healed, but latch still uncomfortable on that side.  Could be

bacterial infection, but seems unlikely if nipple is healed (and no sign of

infection).

>

> Thoughts?

>

> --

> Eden, BA, IBCLC, RLC

> Lactation Consultant

> Atlanta Breastfeeding Consultants, LLC

> www.AtlantaBreastfeedingConsultants.com

> (404)-590-MILK (6455)

>

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You can always contact Edith Kernerman in Toronto Canada.  She can be contacted through http://www.nbci.ca/index.php?option=com_content & view=article & id=62 & Itemid=33   Ghislaine Reid, BA (Translation 1981), LLL (1990), IBCLC(2002)Montreal, Quebec, Canada De : [mailto: ] De la part de TriciaEnvoyé : 10 octobre 2011 15:27À : Objet : Re: deep breast pain At Gold this year, there was a talk about a compression of nerves that mimics vasospasm. I haven't seen any publications yet, but they treated by pectoral exercises. Very interesting!The talk was by Edith Kernerman and was entitled " Mammary Constriction syndrome. I would be glad to send the handout from the talk that I downloaded to anyone, but don't know if that is allowed. I don't feel comfortable posting it here.Thanks!Tricia ELblIBCLC hopeful! Just 3 weeks left to wait...LLL of Roselle/Schaumburg IL > > > > > > > So, in the new BAMS, there are some studies about how deep breast pain between feedings in unlikely to be candida as was thought. My client had nipple damage on one side and is (still pumping and supplementing post frenotomy) and is experiencing sharp pains after feeding in the one breast. I'm thinking vasospasm, but mom has no blanching or color change. No shiny or flaky skin. Nipple damage healed, but latch still uncomfortable on that side. Could be bacterial infection, but seems unlikely if nipple is healed (and no sign of infection).> > Thoughts?> > -- > Eden, BA, IBCLC, RLC> Lactation Consultant> Atlanta Breastfeeding Consultants, LLC> www.AtlantaBreastfeedingConsultants.com> (404)-590-MILK (6455)>

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Thank you for the suggestion! I have contacted her, and will let you all know

her response!

Tricia Elbl

LLL Leader

IBCLC hopeful

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> > So, in the new BAMS, there are some studies about how deep breast pain

> between feedings in unlikely to be candida as was thought. My client had

> nipple damage on one side and is (still pumping and supplementing post

> frenotomy) and is experiencing sharp pains after feeding in the one breast.

> I'm thinking vasospasm, but mom has no blanching or color change. No shiny

> or flaky skin. Nipple damage healed, but latch still uncomfortable on that

> side. Could be bacterial infection, but seems unlikely if nipple is healed

> (and no sign of infection).

> >

> > Thoughts?

> >

> > --

> > Eden, BA, IBCLC, RLC

> > Lactation Consultant

> > Atlanta Breastfeeding Consultants, LLC

> > www.AtlantaBreastfeedingConsultants.com

> > (404)-590-MILK (6455)

> >

>

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Here is the reply I recieved from Ms. Kennerman. I hope it is helpful!

Tricia Elbl

LLL Roselle/Schaumburg

IBCLC to Be

---------- Forwarded message ----------

Date: Tue, Oct 11, 2011 at 3:50 PM

Subject: RE: : GOLD conference handout

To: Tricia Elbl , drjacknewman@...

Hi Tricia,

Thanks for your enquiry. The Gold conference talk is available for download at

http://www.health-e-learning.com/courses/experts-in-lactation/224-xl34 .

The new Pain Algorithm is now available on our website (www.breastfeedinginc.ca

) It helps with assessment and tx of causes of nipple and breast pain and deals

very much with MCS and the PEC muscle massage and stretching treatments. You

might be interested in getting hold of the algorithm to help in your

assessments.

As for a summary, here is what I have been writing to others (please feel free

to share):

In short, MCS is a still-hypothetical dx for a particular group of symptoms

involving breast pain and some nipple pain. The symptoms include deep pain,

sharp shooting pains, burning (cold or hot), dull aches, itchiness, pulsating

pain, and others. It can involve s/s of vasospasm in the nipple as well. The

pain seems to occur mostly after the feedings but can certainly occur during as

well. We did a pilot study in our clinic and arrived at over 40 women whose

s/s were consistent with the syndrome and who responded to the tx.

The theory is that tightening and/or contraction and/or shortening of the

pectoralis muscle (and sometimes the anterior serratus) can cause compression on

the vessels that go the breast. This causes vasoconstriction and then ischemia

and possible hypoxia resulting in pain and symptoms. Lactic acid build up in the

pec muscles can contribute to the pain as well, and can result in pain on touch

as well as pain that worsens throughout the day.

By using pec muscle massage in one of four areas, and doing pec stretches before

or after feeding (depending) can interrupt the pain immediately.

We are in the mid stages of designing a study using Doppler to compare blood

flow in women in whom we have identified MCS compared to women we haven't; and

as well looking at the effects of the pec muscle massage on the blood flow.

Hope that helps,

E

Edith Kernerman, IBCLC, NBCI

President and Executive Director,

International Breastfeeding Centre

Clinic Director, Newman Breastfeeding Clinic

1255 Sheppard Avenue East

Toronto, ON, Canada, M2K 1E2

, phone

, fax

www.nbci.ca

edith@...

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> > >

> > >

> > >

> > >

> > >

> > > So, in the new BAMS, there are some studies about how deep breast pain

> > between feedings in unlikely to be candida as was thought. My client had

> > nipple damage on one side and is (still pumping and supplementing post

> > frenotomy) and is experiencing sharp pains after feeding in the one breast.

> > I'm thinking vasospasm, but mom has no blanching or color change. No shiny

> > or flaky skin. Nipple damage healed, but latch still uncomfortable on that

> > side. Could be bacterial infection, but seems unlikely if nipple is healed

> > (and no sign of infection).

> > >

> > > Thoughts?

> > >

> > > --

> > > Eden, BA, IBCLC, RLC

> > > Lactation Consultant

> > > Atlanta Breastfeeding Consultants, LLC

> > > www.AtlantaBreastfeedingConsultants.com

> > > (404)-590-MILK (6455)

> > >

> >

>

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