Soreness of breast tissue or Thrush?

[@llli*mahme]

Hello everyone,

This is my first time posting on this forum but I have "read" through this forum many times to find answers for many BF problems. I am posting today because I have had an issue going on from a long time and I feel like the docs and LC have not been able to understand. It's a long story so here I go:

About 5 months ago when my DD was born and I started nursing her, I had flat nipples. I was having a hard time getting her to open her mouth wide open to get a hold of my nipple. I took the help of nipple shield to kind of draw out the nipple and then remove the shield to latch her on directly. This was in the hospital. When I went home, I started using the shield again for my right breast since the nipple was very flat and my breasts were huge. I went through a phase of extremely sore nipples which hurt so much that I would dread every nursing session. I finally figured out that her mouth was still not opening up wide enough so worked on the latch more and things got better. In the meantime, I got a cracked right nipple.

When DD was three weeks old, one fine day I woke up in the morning to feed her and as I was moving over in my bed I put all the weigh on my right arm to position myself better. I suddenly felt that something shifted/pulled in the armpit area. It hurt so bad that I almost screamed. I started nursing DD and within an hour I started getting severe chills and then later a high fever. I called the doctor and the doctor who was on call prescribed antibiotics over the phone for 7 days and she said it was mastitis. Later I noticed red streaks coming from armpit towards the breast and also red streaks on the inside area of upper part of my arm. I took the antibiotics for 7 days. Things were better but I was still hurting in the same area (no lumps, no blocked ducts though). 8th day I was okay and on the 9th day it came back again...chills, high fever, etc. Again I was prescribed antibiotics but this time for 14 days.

4 weeks later, I slept on my right breast the whole night and woke up with an inflamed breast, then chills, and then fever. Again 10 days of antibiotics.

After this I continued to have dull pain/soreness in the same area (pain radiating from armpit towards the breast). It would come and go. I used to feel everytime I picked my older daughter or did anything where I use my right arm more, the pain in the area would start. Another 4 weeks later, mastitis came again. I went to the doc, she prescribed antibiotics, probiotics and nystatin for the nipple (so that I don't get yeast infection from the antibiotics). I also got an ultrasound done and they saw no cyst, no abscess but lots of inflammation.

Infection went, the breast inflammation also went away but pain in that same area got worse. Everytime my breast would become slightly full, it would hurt in that area. Now I am in the process of weaning off my DD. The pain is still there. I talked to an LC, she said to take ibprophen and do cold compresses. The cold compresses made it feel even more restrictive. I feel the tissues/muscles in that area (from armpit towards the breast) are still sore. I took 400 mg of advil 3 times for 7 days. It felt temporarily slightly better.

I also got an mri of the pectoral muscle thinking maybe I pulled a muscle (that is how it felt when I got mastitis the first time). The MRI said, it was all good in the pec muscle but they saw a very prominent breast parenchymal pattern (don't know what that means).

Now I have an appointment with a beast specialist in about 2 weeks. I still don't get what is causing this pain. The crack on my right nipple is also STILL there (no pain though)...it has only slightly healed. I am using nystatin on it and pumping only once a day. It is pink in color compared to the other nipple. Could it be thrush that is causing this pain or the inside of that part of the breast is still inflamed? I have read about thrush and thank God I don't feel itching, burning. The only reason I think it could be yeast infection is because 1)I took so many antibiotics 2)the nipple still hasn't healed 3)nipple is pink (no pain though) 4) pain is not like shooting/stabbing pain but more like radiating from armpit towards the breast. Could it be a mild case of yeast infection?Anybody has had anything similar?

Any helpful responses would be highly appreciated.

[@llli*nathansmum]

I had similar problems when my son was young...red streaks on breast, and pain coming from armpit area. I suffered from recurring blocked ducts, and suspect that thrush was part of the problem too. The pain you describe sounds exactly like what I felt, it was the worst when I lifted my arm or put weight on it. Sometimes a blocked duct is very deep and obvious lumps cannot be felt.
Thrush can also be present without obvious symptoms.
This website was very helpful when I was having these problems.
http://kellymom.com/bf/concerns/child/thrush-resources/
http://kellymom.com/bf/concerns/mother/mastitis/

[@llli*mahme]

I had similar problems when my son was young...red streaks on breast, and pain coming from armpit area. I suffered from recurring blocked ducts, and suspect that thrush was part of the problem too. The pain you describe sounds exactly like what I felt, it was the worst when I lifted my arm or put weight on it. Sometimes a blocked duct is very deep and obvious lumps cannot be felt.
Thrush can also be present without obvious symptoms.
This website was very helpful when I was having these problems.
http://kellymom.com/bf/concerns/child/thrush-resources/
http://kellymom.com/bf/concerns/mother/mastitis/

Thank you for your response. How were you able to resolve your problem?

For the ladies on the forum who have had yeast infection, does it hurt in the entire breast or it can hurt only in specific area of the breast? And does it hurt if you touch that area?

[@llli*nathansmum]

I resolved my problem by first making sure the affected breast was emptied and free of plugs.
The best and most comfortable way to do this was to gently massage in hot shower then nurse my hungry baby immediately after. I highly recommend trying this if you can.
I took lecithin to prevent recurrence of the blocked ducts/mastitis.

I was never sure if I had thrush and when I asked my obgyn she couldn't tell either, but she thought it was a good idea to rule out the possibility and prescribed a course of diflucan. Which seemed to help. As well, I sterilized all bottles, nipples, pacifiers, bras etc.
I cut sugar out of my diet and took probiotics for a while.

[@llli*mahme]

I resolved my problem by first making sure the affected breast was emptied and free of plugs.
The best and most comfortable way to do this was to gently massage in hot shower then nurse my hungry baby immediately after. I highly recommend trying this if you can.
I took lecithin to prevent recurrence of the blocked ducts/mastitis.

I was never sure if I had thrush and when I asked my obgyn she couldn't tell either, but she thought it was a good idea to rule out the possibility and prescribed a course of diflucan. Which seemed to help. As well, I sterilized all bottles, nipples, pacifiers, bras etc.
I cut sugar out of my diet and took probiotics for a while.

I have almost weaned her off I get a little over an ounce in 24 hours when I pump. That's what making me doubt that it's a plugged duct since there is hardly any milk left. I do take hot showers when it hurts more and do feel better afterwards. An LC suggested I do cold compresses on the sore area but that made it worse.

Did you do a course of two weeks or a month of diflucan? How much does it cost? I have heard it is pretty expressive.

[@llli*ohiomama]

It must be very frustrating when you are exploring different options and trying treatments that are not bringing permanent relief.

Yeast could certainly be a possibility as it can cause inflammation. It can cause pain throughout the breast. If it is thrush, diflucan may be needed to fully treat it. I'm not sure if you and your doctor have already explored this, but ruling out a staph infection might be something to explore as well.

Breast tissue can extend into the armpit. Some women are more prone to plugs in this area for a variety of reasons, such as tight bras or shirts, sleeping positions, high amounts of saturated fat or sodium in the diet, anemia, food allergies and more. Warm, moist compresses and gentle massage over the affected area are both good for plugs. Lecithin and warm showers, as the PP mentioned, are helpful as well. If motrin is not bringing relief, you may ask your doctor about trying another anti-inflammatory.

I hope you find some relief and answers.

[@llli*nathansmum]

Did you do a course of two weeks or a month of diflucan? How much does it cost? I have heard it is pretty expressive.

It was just a few days, 5, I think...although I believe it is usually prescribed for at least 7. It was about 20$ per tablet, one a day

[@llli*mahme]

Thank you ladies. Appreciate your helpful answers. I had my appointment with the breast specialist and she said that the muscles in the breast have thickened (causing tenderness) as a result of repeated mastitis. There is not quick fix to it; time will heal. Not a very encouraging response but thank God it is not something to worry about. I just hope that it does get better with time.