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Clinical Crossroads Update
October 24/31, 2001

A 35-Year-Old Woman Experiencing Difficulty With Breastfeeding, 18 Months Later

Author Affiliations

From the Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, 330 Brookline Ave, LY318, Boston, MA 02215.

JAMA. 2001;286(16):2022. doi:10.1001/jama.286.16.2022

In December 1999, Ruth A. Lawrence, MD, discussed the differential diagnosis and management of breast and nipple tenderness associated with breastfeeding in a 35-year-old woman who had just delivered her first child.1 Pregnancy and delivery were uneventful, but 24 hours following parturition the patient, Mrs C, developed bilateral nipple tenderness associated with cracked skin and bleeding. After 4 days of slow improvement, Mrs C noted a lump in her breast near a nipple, skin soreness, and low-grade fever. She did not take antibiotics offered to her via a telephone consultation and turned for advice to a pediatrician who advocated homeopathic medicine. She used 3 herbal preparations—Echinacea, belladonna, and Phytolacca—and her symptoms resolved 24 hours later.

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