Dear all,

I have a mom of a three week old who is still having severe latch-on pain on
the right side.  I saw her about 1 1/2 weeks ago, and positioning et al is
good.  The nipple had been sore all the way through the feed; now it's only
painful on latch.

Haven't had a chance to see her again -- she just called, and so I'm going to
query the group before I set up an appointment with her.

1.  Pain is only on right -- left side feels great.  Pain lasts 15 to 20
seconds, but is excruciating.
2.  Nipple is blanched after she is finished, but briefly -- maybe 10-15
seconds.
3.  No pain after feeds.
4.  Occasional pain between feeds especially when it gets a breeze on it
(reminiscent of Raynaud's, but....)
5.  No tingling or numbness during or after feeds.
6.  Pain feels like a severe burning.
7.  Nipple has no cracks/fissures, but is pink about 1 cm all the way around
the nipple on the areola.  Also there are no visible Montgomery glands on
that side like there are on the left side.
8.  She has used several different positions w/ no change in pain level.
9.  Baby opens very wide and she's pulling him well onto the br tissue.
10.  The only difference she can really tell on the shape of the nipple after
feeds is that the right is not extended nearly as long as the left after a
feed -- but why would that be?
11.  Any guesses?  For the moment, I've asked her to pump/express briefly
until she lets down just to see if that will help ease the pain somewhat.

ideas?

Thanks!

Jan Barger, RN, MA, IBCLC
Wheaton, IL

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