Looking for further insights.  I am working with an Asian mom  who is
again having severe nipple breakdown. I had worked with her with her first
baby and after 1 minute suckling her  anterior nipple base develops severe
fissures. Even with different positions and a great latch ( well shaped
and elongated nipple/areola with no distortion), we were never able to
prevent fissuring. At that time, I tried treatments for possible yeast and
later staph with no improvement. Using a nipple shield made no difference
and the same situation occured with every and all breastpumps and
settings. Despite all this- this mom breastfed for 7 months! When mom
weaned, the fissures healed.
 Now 16 months later and a new baby, same situation. Right after delivery-
with a great latch in 1 minute a fissure opened up despite everything and
the second she put baby on the other breast- same thing.
 I've received permission from her Dr. and we have located a compunding
pharmacy which will make up Dr. Jack's cream to try this approach but I
thought I'd also see if anyone has any other idea's. She experiences no
damage in any other area of her body and otherwise heals well, so I doubt
some type of connective tissue disorder... any idea's?
TIA- Lisa

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