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Pain in Thumb when Breast Feeding

7th January 2019
By Lisa Keenan

Pain over the base of your thumb, the thumb side of your wrist and sometimes up into the forearm (See picture below) can happen when you start breastfeeding your baby.  Mothers can often find when their baby is under 1 year old that they experience this pain. It is called DeQuervain’s tenosynovitis or it may be referred to as “washerwomen’s syndrome”.

You can diagnose DeQuervain’s tenosynovitis by doing what is called the Finkelsteins test. You can do this test by yourself. It is done by bending your thumb into the palm and grasping around your thumb with the fingers. This is making a fist with your thumb inside as shown in the diagram below. Now bend your wrist away from your thumb in a side to side motion. If you have pain in the tendons of your thumb when your wrist is bent towards the little finger side of the hand, you probably have DeQuervain’s tenosynovitis.

DeQuervain’s is inflammation of the two tendons that control the movement of the thumb and the sheath that surrounds them. DeQuervain’s tenosynovitis often occurs with repetitive movement of the wrist from side to side and holding the wrist in a sustained ulna deviated position (particularly when using the thumb to grab something).

When it occurs in breast feeding it is usually due to the way you are holding the baby’s head whilst it is feeding. These positions are usually sustained for long periods of time. It can also be affected when changing the baby’s nappy with the strapping/unstrapping of tags on the nappy.

Initially you can try holding your thumb close to your palm with feeding and nappy changes. Sometimes ice can help settle the pain. This should be placed over the thumb side of the wrist. Wrap the ice in a tea towel and be sure not to burn yourself with the ice.

If the pain does not resolve a visit to a hand therapist will help with the inflammation, they are likely to supply you with a hand splint. This splint should be worn every time you are feeding the baby. Besides helping with the inflammation, the splint will enable you to learn a new way to hold the baby when feeding that does not irritate the tendon.

It is important if you are having this pain that you treat it whilst your baby is small. As your baby starts to get heavier your symptoms can worsen with the way you pick up the baby. Treatment for this condition is usually successful with hand therapy.

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