Saw an interesting case today and wanted to see if others of you had any
suggestions.
Second time mom who nursed her first 6 months.  About 4 months along she
developed a cracked nipple (actually at the base of the nipple) which
eventually led to an infection and mastitis which she states wasn't
discovered until several weeks of Rx for thrush did not lead to any
improvement.  (I had not seen her at this time.)  Now with her second baby,
she reported soreness right from the start.  No real red flags for thrush.
Position and latch looked good from the start.  She came in for an
outpatient visit with baby at 6 days.  Weight was nearly back to birth
weight and there was no concern with supply.  However, she was complaining
of excruciating pain and a cracked nipple.  Everything looked normal except
for a small shiny line where she indicated the pain was.  She thinks it's
the same location as the crack with her first.  There was no tenderness
anywhere else and no warmth or redness that would make me suspect any
infection.  We worked on refining the latch-exaggerating the asymmetric
latch a bit and she reported it still hurt, but not as bad.  We took baby
off and the nipple was symmetrically shaped, but the line was wider and
shinier-no redness or bleeding.

My first thought was it looked like a stretch mark.  I wondered if it was
the same spot as her problems last time if that area wasn't as elastic as
the rest of the nipple and if indeed it was the same as a stretch mark an
expectant mom might get on her breast or belly.  She very much wants to give
that nipple some rest and pump a couple days (she's very frightened of
having the same experience she did with her first).  Pump hurt, but not as
much as baby nursing.  I gave her suggestions re the pumping (lubricate the
flange with some water or expressed milk so it doesn't "grab" the nipple-use
larger flange).  I also suggested using cocoa butter or olive oil on the
line on the assumption it was a stretch mark.

Do you think it was a stretch mark?  Any other ideas?

Winnie

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