Hello, I am the childbirth educator at Womack Army Medical Center.  I work
with a lactation consultant providing both inpatient and outpatient care
regarding breastfeeding.

I have worked with a mother who is an RN.  The baby is 3 months old now (was
10lb 12 oz at birth).  Initially she presented with very damaged nipples,
yeast and red streaks leading back from the areola.  Her dh is a Family Prac
MD.  He prescribed Diflucan for the yeast and when no change in yeast within
5 days, changed the dose from 100mg daily to 200mg.  She stayed on that for
3 weeks to get rid of the yeast and by the end of three weeks the nipples
were so damaged, she was essentially missing half the nipple on the left
side.  Baby latched well, but a had a slightly tight frenulum, eager nurser.
At 3 1/2 weeks, Mom quits putting baby to breast and pumps only with a
Medela Pump N Style.  She is an excellent pumper, getting 10-16 ounces at a
time.  Baby is fed by bottle.  Question:  At 3 months, her nipples stick
crack open and bleed even on the lowest setting of the pump.  She has to
ease into pumping to avoid more severe damage to the breast.  What could be
causing this?  Is it possibly underlying yeast, a skin condition, never
healed damage from the beginnning...or something else?  She is active duty
army and is considering pregnancy again soon...for various reasons.  She is
not looking forward to nursing another baby, especially since she cannot
even pump in comfort.  Has anyone seen this?  Any ideas for her?  Thank you
so much for your time.


Becki Britt
Childbirth Educator
Womack Army Medical Center
(910) 907-7102
http://www.wamc.amedd.army.mil/pregedu/

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