Muddana Anitha, Asbill Diane T, Jerath Maya R, Stuebe Alison M
1 Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill , Chapel Hill, North Carolina.
2 Lactation Services Department, University of North Carolina Hospitals , Main Campus, North Carolina Women's Hospital, Chapel Hill, North Carolina.
Breastfeed Med. 2018 May;13(4):275-280. doi: 10.1089/bfm.2017.0158. Epub 2018 Apr 9.
It is not uncommon for mothers to have persistent pain with breastfeeding beyond the first few weeks after birth. Persistent pain can be multifactorial, with neuropathic pain maintained by central sensitization being one dimension. Our knowledge in delineating categories of persistent pain is simple and not very sophisticated.
We have developed and tested a Lactation Quantitative Sensory Test (L-QST) to quantify the neuropathic component of persistent breastfeeding pain. We present three case reports of neuropathic breastfeeding pain and treatment, and we discuss the potential role of histamine and catecholamines in persistent breastfeeding-associated pain.
The L-QST can be a useful tool to quantify neuropathic pain. Further studies are needed to test inter-observer reliability and reproducibility of this tool. Antihistamines can be considered for treating persistent pain in breastfeeding women with a history of allergy or atopy, and beta-blockers may be helpful in women with multiple pain disorders.
产后最初几周后，母亲在母乳喂养时持续疼痛的情况并不少见。持续疼痛可能是多因素导致的，其中由中枢敏化维持的神经性疼痛是一个方面。我们在区分持续性疼痛类别方面的认识简单且不太成熟。
我们开发并测试了一种哺乳期定量感觉测试（L-QST），以量化持续性母乳喂养疼痛的神经性成分。我们呈现了三例神经性母乳喂养疼痛及治疗的病例报告，并讨论了组胺和儿茶酚胺在持续性母乳喂养相关疼痛中的潜在作用。
L-QST可以成为量化神经性疼痛的有用工具。需要进一步研究来测试该工具的观察者间可靠性和可重复性。对于有过敏或特应性病史的母乳喂养女性，可考虑使用抗组胺药治疗持续性疼痛，而β受体阻滞剂可能对患有多种疼痛疾病的女性有帮助。
