Hi Pamela,
I did personally see the cracks and they are small, thin, red and superficial on the nipple face only.  The mother has not reported seeing any blood in her milk when she pumped.
The good news is that she contacted me yesterday and reported a dramatic improvement in the cracks since restarting her prenatal vitamins several days ago which she had forgotten to take since delivery.  Hopefully they will finally heal.

Take care,
Amy
Sent from my iPhone

> On Apr 12, 2015, at 5:09 AM, Pamela Morrison <[log in to unmask]> wrote:
> 
> Amy
> 
> Have you _seen_ the cracks??  If so, what do they look like, and is there any bleeding?
> 
> Just wondering if the mom is mis-interpreting normal nipple creases for cracks and if you're talking on the phone rather than face to face?
> 
> Pamela Morrison IBCLC
> Rustington, England
> ------------------------------------------------
> Hello Everyone!
> 
> PTP:  I am working with a mom who is exclusively pumping.   Her baby is almost 6 weeks old.  She has developed new cracks on the face of her nipples and I am at a loss as to why.  The flange fit is optimal, she's using low suction on the pump and she's caring for her skin appropriately.  I have recommended renting a hospital grade pump but the mother is reluctant due to the cost.   I encouraged her to call her MD for a rxn for MD for APNO cream.
> 
> Any ideas why the cracks are occurring?
> 
> As always, I truly appreciate all of your help!!
> 
> Amy
> 
> Amy Wagner, BS, RNC, CCES, IBCLC
> 
> 
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