Sarah,

The crack is probably caused by both the thrush and the pump.  The thrush will leave the skin fragile and prone to cracks.  The pump is putting stress on the tissue in such a way that it re-opens the crack.  Treat the thrush.  Suggest to the mom that she experiment with pump settings and flange positioning to find a way to pump without further damaging the tissue.  Or she may want to hand express on that side for a few days.  Or perhaps her manual pump may actually be better in this situation.  If she begins to treat the thrush aggressively, the crack may heal anyways, even if it is slightly aggravated by pumping a couple if times a day.
Warmly,
Sharon Knorr, BSMT, ASCP, IBCLC
Newark, NY (near Rochester on Lake Ontario)
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