Hi everyone,
I am a lurker until now and must say that I have learned so much from all
of you over the past months. I am a Public health nurse and a relatively
new LC since the fall. I have worked with breastfeeding moms for over 10
years and as all of you are, I am passionate about it. I have a situation
that is stumping me and need your expert ideas and opinions. My community
is very small with 500 births per year so I don't get to see the variety of
situations you all do and hope you can share your collective knowledge. I
have sent these questions to Dr. Newman earlier this week and he has
suggested to continue to treat for yeast and possibly try laser to heal the
wounds or seek opinion from a dermatologist. We do not have access to
either in our small community . Here the story goes... Sorry it is so long.
I am working with a mom who is nursing her 12 month old daughter and has
run into complications. In early April her daughter was very sick
hospitalized and diagnosed  with RSV . Baby had a course of antibiotics-
Amoxil following her admission?? Mom is unsure of why. One week after she
was discharged mom developed open areas on both nipples. I suggested APNO
which work wonderfully for a few days to relieve her pain. The open areas
however have now gotten worse and seem to be spreading.The baby has since
developed a yeasty diaper rash. She started gentian violet on  and will
continue to apply it for one more day. She continues to use the APNO. She
is open to trying grapefruit seed extract if we are sure it is yeast. She
has some pain but not as much as you would think to look at the nipple
areas. The baby nurses around 6 times per day. Mom has always lied down to
nurse her. No real change in her positioning.  The areas that are opened
are at the top of the nipple where the tissue attaches to the areola and
several small spots above ( where the babies teeth would rest) No unusual
stuff in babies diet. No new toothpaste . Nothing that mom can think of.
One more thing- When baby was sick she had blisters inside of
her mouth which the doctor felt was related to fever. What does herpes
present like and could it be that? If so how do you treat it. The sores
don't look bacterial. No discharge. Should they be cultured anyway?I hate
to get into oral antibiotics if it isn't bacterial and make the yeast worse.
Does  yeast sometimes spread like that?
How long in your opinion do open sores caused by yeast take to fill in and
heal. Lots of questions !! Hope you can provide some guidance. Mom is
reluctant to stop and is enduring the discomfort but worries that they are
spreading. She has an appointment to see her family doctor  this week . He
would be open to any suggestions I would make. Thanks in advance for your
expert help.

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