I have a client, para 3, previous 2 babies breastfed for 6 months.
She developed a crack in the nipple antenatally, small and centrally
situated.  Was advised to apply lanolin, now ceased that due to it
been of no help. Nipple painful to feed from from birth.  Baby now 3
weeks old, crack still there and very painful during and after feeds.
 Mastitis in that breast 1 week ago, now cleared.  Mum reluctant to
feed from this side due to pain, so feeding once or twice a day from
this side.  I am treating Mum and baby for thrush since the signs are
"razor blade type pain", itchy nipple", nipple extremely painful",
deep breast pain.  Baby has no thrush on nappy area, may have it
orally (unconfirmed).  What I want to know is why did this crack
develop antenatally?  Is it hormonal changes?  This is what I have
suggested.  Is it thrush, or am I missing something?
Val in Busselton, Western Australia
RN RM IBCLC