I am posting this question for a fellow LC.  She is working with the
mother of a 5 1/2 week old who is thriving at the breast.  Mom has
reported pain with BF since the beginning and they have been working on
it right along with all the usual suggestions.

Recently, she has developed white areas on both nipples that resemble
callouses.  One is round, the other L-shaped.  The nipple is very
painful  when she nurses, but the breast is soft, does not hurt, and
shows no signs of mastitis or plugged duct.  The baby's palate slopes
nicely, but has a hard ridge at the back.  Occasionally she has some
blanching of the nipple.  The nipple sometimes looks "squished like a
sandwich" when it comes out after BF.  But these things do not happen
every time.  Mom's palate has a bump.

Could these white spots be callouses from abrasion.  Is there anyway to
avoid contact with the back of the baby's palate ridge, if that is what
is causing the problem?  She has tried different positions, but usually
uses the cradle hold.  Might the white spots be something else?

Please reply to my e-mail address as well as the list. Thanks.

Barb Berges BS, RN, IBCLC
Rochester, New York