Dear Friends:
    I have been working with a mother whose baby sucked his lower lip in
utero; in addition, her positioning at breast needed improvement. So we have
been working and things are getting better. Much better. All was well until
yesterday, when she began to complain of nipple tenderness all the time,
getting worse, can't even wear clothes. She has a strong history of yeast
infections, last one two months before delivery. I suggested some things to
see if they would help.
Plan was to call her today, at our usual time.
    This morning, I called the pediatrician to commend him for his fabulous
advice to her at the visit on Monday (4/10). It is so helpful when the
pediatrician is calm, and supportive of breastfeeding. He was glad to hear
from me, said that he had to be a model for the residents. Then we talked
about this case, and he mentioned that he had noticed some thrush on the
baby's tongue on Monday, but "not enough to treat." I said that the mother
was having some problems and he suggested she call him for a prescription to
treat mother and baby.
    I am amazed and annoyed that the pediatrician  would see thrush and not
treat it. If he had treated on Monday, perhaps the mother wouldn't have gone
through a spell of discomfort and also dealing with a baby who can no longer
be consoled at breast....probably because his throat feels like her nipples:
tender and sore.
    The message is that dialogue with the other healthcare providers in the
case is important.
    Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI, CSTP
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporter of the WHO Code and the Mother Friendly Childbirth Initiative

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