Breast Pain

by Heather

I have a 9 month old daughter that I have breastfed since birth. I am experiencing crazy pain after feedings - its intermittent, doesn't happen with every feeding and has mostly been in my right side, but has happened in the left side sometimes too. I have been through treatment with nystatin cream, gentian violet, APNO (Dr. Newman's recipe) and I'm currently 18 days into treatment with fluconazole. I really haven't experienced much improvement, except for a little less nipple soreness, and a little bit less frequent bouts of deep pain. The pain usually starts about 10-20 minutes after feeding and lasts for 1-3 hours, sharp, stabbing pain that is as painful as childbirth! Taking Advil hasn't helped at all! Is this thrush, or is there some other cause for this type of pain? I should add that I did have mastitis at one point in the middle of this ordeal, but the pain was completely different and I went through 10 days of Antibiotic therapy. I have also had plugged ducts at different times during this lactation, but this pain is different than that too. My other question is whether weaning will help get rid of the yeast or make treatment easier? I am really tired of this pain and I want to find some way to stop it from recurring! Thanks!

Answer from the lactation consultant:
Goodness, you are really a trooper. Sounds like you have been through a lot. Many would have already quit, I am proud of you for sticking with it.
I believe you are exprienceing vasospasms as a result of the mastitis and thrush. This often occurs after infections. It is where your veins in the breast spasm after the feed or during the feed. Many describe it as the feeling of being stabbed in the breast. Another common finding with vasospasm is the nipple changing color during or after a feed, going to purple or white.
I would make an appointment with your physician and mention this to him, explain that it is linked to Raynauds Phenomenon.
Treatment can be as simple as applying warmth during and after the feed to your breast. NO smoking cigarrettes and no caffeine. (both will make it worse) I had one client experience relief from taking Calcium and Magnesium supplements. However, most who experience severe vasospasms must be prescribed NIFEDIPINE by the doctor. It provides fast relief. It will widen the vessels so that they do not constrict and cause pain. There are special precautions that should be taken when you are on this medication, so ONLY use it under medical supervision. I am not a doctor and am not licensed to ok this, I am simply offering suggestions as to what has worked with my clients in the past. (disclaimer).
I hope this information helps, Please keep me posted on your progress.
Liz Pevytoe, RN, IBCLC