Is this a problem which is new or been there right from the beginning, or gradually increased.?
If the nipples look happy, I guess you mean that they dont look like there is any thrush/staph - was there anything in the history to suspect that it could be?
The well nourished baby is good, but it may also be that the mother has become a little laise-fair with the attaching. What type of palate does the baby have? Were you able to watch a whole breastfeed and observe the nipples for a period of time afterwards?
It may be that the nipple is moving around ( clicking during feeds, sliding in and out)or being bent around the corner during the feed.( often discounted if there is no external damage) The mum's good milk supply enables the baby to gain weight well, but the nipple is suffering. As each week progresses, the nipple becomes more irritated and less tolerant of being mistreated. The nerve endings become damaged; each feed re irritates the nerves and hence the pain always post feed. If there is no vasospasm now, then it may well start if this continues. The position of the burning occuring above the areolar might be as a result of the baby being positioned too far around to the mothers side ie. the baby's top gum is being pushed into the areola during feeds- often happens as the baby gets too big for the mother's lap, and instead of moving the baby out at a diagonal to give more room, they tend to move the baby around the corner.
that's my 2cents
Bridget

hi bridget
could this be a fungal infection of the nipple and areola?how do we rule this out?

Fungal infections of the nipple will usually look red, pimply, rashy.
Julie said the skin looked happy.
Staph infections on intact nipples can be harder to detect because often they dont look like anything.
A swab can be taken to rule out fungus and staph.
Infections can be on the areola as well, but it would usually be all around not just on one spot ie Julie said it was very sensitive just above the nipple.
The mother may like to try some antifungal cream - especially if she is in a hot summer climate. If it is fungal, she will notice some improvement within 1-2 days.

I wonder if Julie can let us know what happened.
Bridget

I actually experienced a similar feeling when I breastfed my child. It was generalized in the breast and an aching feeling or squeezing/burning feeling after feeding. I always wondered what it was. My child nursed well and would empty both breasts each feeding. No sore nipples. I just attributed it to irritation to the ducts passing all that milk along. I only had mastitis once early but this feeling was present every feeding for the several years I nursed.
Anyone else??
Cheryl

hi Denise,
could that pain expierenced by Cheryl(as mentioned above) be due to painful letdown? do many women expierence it, and in that case should we just advice them to live with it?( i think that's not easy. i wonder how Cheryl could do it) are we missing out on something?

eagerly waiting for your reply,
preeti

I don't really know Preeti. I think maybe you are right - the contraction of all those little myoepithelial cells in the breast just stay contracted too long and begin to ache.
If the pain settles fairly quickly this could be the reason. I wonder if warm packs after breastfeeding would help.

You say, it's not easy and wonder how Cheryl could do it. That is true and I really do take my hat off to what some mothers go through to continue to breastfeed their babies. However, I think there are also quite a few who give up very quickly at the first sign of a problem. What these women don't consider is the pain they will experience sitting beside their infant as he struggles to breathe with a chest infection, or watching their child lose weight as they have diarrhea and vomiting, or are crying with earache, or heaven forbid, are learning to inject themselves with insulin because formula feeding is the biggest cause of diabetes mellitus in children ... or further on in their future just missing out on that university place or great job because their grades were just not quite good enough, formula feeding having robbed them of a few IQ points. And, dare I say it, mostly its because the mothers aren't even told about these future pains.

OK now I daresay what I have just written will ruffle a few feathers. Before you tell me how mean I'm being please consider not shooting the messenger. All I have done is reiterated SOME of the many research-proven FACTS about infant formula feeding. I personally didn't do the research that found out these facts.

And yes, there are mothers who have no choice but to give their infants artificial formula. For them, forewarned is forearmed. They can be extra vigilant with their child's health. And they can be reassured that though it is not human breastmilk they are giving their child it is the next best thing available and without it their child would be a lot worse off. We all have to do what we have to and when there is no choice we are extremely fortunate to have infant formula available. But breastfeeding should never be given away lightly.

thank you Denise
preeti

I have had pain in only my left breast when it is emptied. It's a shooting pain, almost a long throb that feels better if I put pressure on it. It's not explained by clogged ducts, mastitis etc. I've had many problems in the past, clogged ducts and nipple blebs but this is different. Was going to just push through the pain but may call the OBGYN. On an unrelated note- or possibly it is related- my daughter (4 months) has had watery BMs for 2 weeks. Our pediatrician says it's "normal" but maybe it's related to the pain?

Sarah - the pain sounds awful. WHen you grab the breast to apply pressure, you are actually blocking the nerve pathway.
Please ensure a proper oral assessment and re evaluation of latch by an IBCLC with specific skills in this matter.

Some of your history is probably related to your current situation. It is very difficult without a detailed history and oral examination of your baby. So I will just offer some general pointers as this is a health professional forum. Please ensure a proper physical, oral assessment and re evaluation of latch by an IBCLC with specific skills in this matter.

Please read my post from 15 January last year. The etiology of neuralgia is complex with nipples. One sided pain indicates to me that it is not likely to be a thrush infection however it is possible that it is staph. Also, you have a history of mastitis, plugged ducts and blebs -whilst there is an element of infective cause with mastitis, the plugged ducts and blebs have a physical cause.
4 months of physical compression will certainly result in this type of pain. Partly because the nerves just cant take it any more and partly because the physical size and position changes as the baby gets older and many mothers do not allow for this. I would be suspicious that latch on that side has not been 100% perfect for a long time.
I see that you make the relationship between the breast being empty and then pain - the breasts are drained following the baby sucking -it may well be the sucking which causes the pain not the emptiness.
You have reported any vasospasm - have you specifically looked for it when you get the pain?

As to the baby BO changes - I dont know if it is related;
Antibiotics (maternal) can cause longterm bowel disturbance in babies; failure to drain fatty portions of the breast can also create looseness; accumulated food intolerance via breastmilk will disturb bowel function. Little notice is taken of this if babies are thriving - but their body is trying to tell you something.


breast wishes
Bridget

Denise,

I just have to comment that I full concure with you and I think our society is so 'politically correct' that women aren't told all these risks flat out and therefore choose the 'easier/more convenient (if you can call it that) option. Its can be so frustating some times!