Hi- a brief introduction as I am mostly lurking and learning lots of
fascinating things. I am an RN, IBCLC at a large teaching hospital in Florida. The
mother who needs help is actually not a patient, but someone that I know from the
community. I have her permission to post, in the hope that there will be some
good ideas for her out there. The history is a bit complex. After several
homebirths and great brf experiences, this mom gave birth to a baby with Downs
and many complications, including cardiac. The baby was not able to suck for a
very long time, had surgeries, mom pumped, etc. Finally, after many months,
baby miraculously was able to nurse. He is now 2 1/2 years old, has feeding tube
thru which he gets alimentum (many allergies, this is what he tolerates at
present) and was nursing 5-6 times a day until the present problem.
About a month ago, mom had some cuts on her nipple which were painful and
bleeding. She attributes this to the baby starting a cold & possibly biting her.
the baby was hospitalized for about a week & a half with pneumonia (viral) a
tracheal infection (Viral? not sure) and an infection at the feeding tube site.
Baby was treated with antibiotic. Mom was seen by an LC at that hospital for
crusty, draining nipples. The LC suggested she see MD. Based on this without
actually seeing her breasts, the pedi prescribed Keflex for the mom. Baby has
candida on a regular basis & has been treated with nystatin & Diflucan. He
presently has no outward symptoms.There was some discussion between the pedi & the
infectious disease MD that mom's nipple infection might have played a role in
the baby's latest illness. The drainage & the milk were never cultured. Mom
feels that things are worse since the Keflex.Presently mom has crusty nipples
(returns after bathing), "deep itchiness" which she decribes as feeling" almost
like something that feels better after you scratch it & it hurts" The feeling
is worse right after a feeding. Baby now nurses only 2-3 times daily, since
mom is torn between feeling that her son needs every ounce of immunity she can
provide him with and concern that she is possibly infecting him. My own
feeling is that this is mostly candida, with some bacterial infection of the nipple.
I'm sorry that this is so long, but I felt that the background was necessary.
Any ideas from the collective wisdom of Lactnet are appreciated. This is a
very dedicated mom.
Thanks
Carole Glatter, RN, IBCLC
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