Esther describes a Mom and baby, 11 wks old presenting with R sided breast
pain, she suspects is related to thrush but Mom has been inadequately
treated. Complicating variable is that baby routinely vomits blood after
nursing on affected side only but pumped milk is blood free. We are told that
Lside is smaller than R, but don't know the clinical significance of this ie.
does the left have an undersupply issue and the right is just fine! Or does
the right have an oversupply and the left is just fine?
Course up until this point has included nystatin and low dose diflucan for
yeast, pumping and freezing milk with plan for invasive diagnostics per MD.
IF you highly suspect yeast than obviously Mom needs appropriate course.
Whether or not you further treat yeast, would suggest a few days
antiinflammatory-ibuprofen, to combat possible inflammatory process/pain. I
don't think you said, but does Mom have pain when she pumps? Since pumping
doesn't result in bleeding, we might assume that the compression portion of th
e fdng at breast vs. suction only with pumping is resulting in bleeding. Thus
I might endorse  a few day break from nursing-pumping only and when nursing
resumes, appropriate attention payed to positioning ie. is she a cradler? try
f-ball etc. I don't understand the suggestion to freeze milk. Whats the point?
Would DEFINITELY work to r/o other causes before jumping on invasive
diagnostics since many women experience some bleeding with breastfeeding and
often the causes are poorly understood.

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