Barbara,
I *really* appreciate your response.

I tried to be very thorough, but I realize I missed a couple of things, *and*
misstated that she has seen an allergist. She has seen *3* dermatologists!
One said psoriasis, one said excema and the last one, who was the only one
knowledgeable about bf said yeast. She did have a culture done; the other
mother has not. (more below):

In a message dated 4/18/00 7:27:10 PM, [log in to unmask] writes:

<< If a person goes through dramatic and persistent  therapies (here a 2 year

long effort!) to clear up a condition and is, in the end, no better, I'd say

logic requires a reconsideration of the initial diagnosis and a change in

the direction of the therapy.>>

She has treated this in a variety of ways (not all at once), as if it were
yeast, and as if it were excema. You are right, though, that when I see the
tissue, it does not look like yeast, and I have told her this.

<< I am curious as to whether the assessment of these nipple lesions has

included cultures to see what they grow.  Friable tissue such as Jennifer

describes does sound awfully like eczema, and the skin probably infects very

easily given the continuous breakdown of the tissue and the exposure to the

germs of the mouth of a normal child.  What sounds conspicuously absent in

the review of treatment is the standard tx which would be (in the lit.)

antibiotic therapy for the deep breast pain and the skin that can't heal,

along with strong steroid cream topically.>>

As I said, neither mother has deep breast pain--it is only the nipples and
surrounding tissue which are painful. You are right that neither mother has
chosen antibiotics or steroids. That would not be the choice of either woman,
but I will pass along your suggestion. You are making me think, though, that
a more aggressive natural approach to excema might be useful.


<<I am also deeply suspicious about elimination diets that go on for years in

the absence of any sign that they are helping.  Is it possible that without

adequate protein, fats and perhaps carbs too, this mother has a dietary

deficiency that is breaking down her skin? Is the diaper rash in the infant

perhaps a clue.?  Infants who are low in zinc often have terrible and very

persistent diaper rashes that improve with additions of balanced nutrients

to the diet.>>

Mother A did not eliminate all foods at once and it is very clear to her that
her son is allergic to dairy and gluten. She did not realize the gluten
allergy until quite recently. She did reintroduce foods which were clearly
not a problem, like corn. The zinc question is a very good one--I will
suggest it to her. I do not believe her diet is inadequate and wonder still
(as the other mother eats a much more mainstream diet) why both mothers have
the same problem. Perhaps they do both have excema. For both mothers, being
vegetarian is an ethical choice, not part of an elimination diet.


<<Vegetarians and vegans must be very careful with their own diet and when

offering weanling foods because it is difficult to provide sufficient

quantities of protein, many nutrients, and some important vitamins. >>

I do appreciate your input on this, but as a vegan of 12 years, who has
raised exclusively vegan children (ages 20mos-11yr), I do not agree w/ this
information. I have read extensively on this topic and feel very
well-informed. My children have never been anemic, almost never get sick and
are not lacking in sufficient quantities of nutrients. As a matter of fact,
dairy consumption is the major cause of anemia in children. However, I will
certainly forward all of your information to her. (Also, both mothers ate
dairy when pregnant).


<<What I do know is that people on restrictive diets must have education about

replacing nutrients that are so easily obtained from meat, eggs, and dairy.

If there is a chance that dietary dificiencies may be playing a role in in

skin conditions and recurrent infection, LCs must know something about

nutrition or at least know a good nutritionist or nutrition book to guide

parents.  And they must beware of instructions to further restrict diets

that may remove even more sources of essential fatty acids and nutrients for

good skin health.>>

I agree w/ you that it is helpful to be knowledgeable about nutrition. I
referred this mother to an excellent nutritionist many months ago, who gave
her specific supplements and told her to take flax oil, as well as making
dietary suggestions. I also suggested she has a stool sample done to
determine if she does indeed have systemic yeast or if there might be some
other nutritional imbalance. She is awaiting those results.

Again, thank you very much--I will pass along all info and ideas, and you
definitely have me thinking again about excema. One last question--would
staph be something to consider?

Jennifer Tow, IBCLC, CT, USA

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