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Thu, 18 Apr 2002 11:33:54 EDT |
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Consider bacterial infection, ductal thrush and reynaud's phenomenon.
Visualize the nipples/areolas for any flakes, crusts, redness. Culture the
breastmilk after a few minutes of feeding. Check for reynauds, if you don't
see any change in nipple color (white, red, blue) , look for any signs of
yeast in infant or mother. Ask about a history of yeast in the mother. I
have seen bacterial ductal infections with the only sign being a 1 mm honey
crusted flake on the areola. Then give a trial of whatever seems most
likely (yeast or bacteria). Get her something stronger for pain (Tylenol
with codeine perhaps--is she taking max doses of advil- 800 mg tid?).
My guess is that is is yeast--can cause the plugged ducts to begin with.
Christine Betzold NP IBCLC
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