Hi,

I'm hoping some-one can give me some ideas on this.  I spoke to a mum today,
she has an appointment to see me Monday.  She is breastfeeding her 3rd child
who is 3 weeks old.  She has a 6yr old whom she breastfed for 2yrs, and a
3yr old whom she breastfed for 14mnths.  No problems BF her first.  However,
shortly after her second was born she developed a crack in one nipple.  She
has had this crack for 3 years.  It apparently crusts over, begins to heal,
and then breaks open again and becomes weepy.  No problems on the other
side. Her 14mnths of breastfeeding her 2nd baby were agony, and she feels
she had to wean him prematurely.  She tried to stop feeding on that side,
but got mastitis.  She had a biopsy about a year ago.  That showed up
nothing, and the  summary from the pathology was "spongeotic inflammatory
reaction"  Her doctor is quite stumped.  Over this time she has treated the
nipple with antibiotic creams and daktarin, but neither worked.  She has no
skin allergies, and feels her skin is not particularly sensitive. She's
allergic to sulphur based medication.  She described "shooting, stabbing
pain throughout the breast, radiating from the nipple.  Breastfeeding is
agony"  She doesn't have any other problems with thrush. The only other
thing she mentioned was that she had felt it was related to her monthly
cycle, healing towards the end of her cycle.  she is very conscious of
correct attachment and positioning, air drying etc.
Any ideas?  What should I be looking for when I see her on Monday.  Any
suggestions on how to treat it?
TIA
Barb IBLC Australia
Mum of Zac, Dan and Cassie
Australian Breastfeeding Assoc Counsellor
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