I have 37 wk twins born with short frenulum. Nipples cracked,
hyperlactation observed, mother producing 10 oz milk on day 4. Frenotomy
done. Nipple pain resolved for 5 days. Mother developed mastitis day 7,
antibiotics started, mother pumping and feeding through mastitis x 2 days,
then back to total breast. Mother developed ductal yeast 7 days after
antibiotic, diflucan used, breast pain resolved, nipple pain continued to
be present through the 14 days of diflucan. Nipple pain and latch reassesed
by this L.C., nipples appear pink, very minimal to no nipple compression
noted. We tried nipple shield with no change in nipple pain we changed size
of pump flange, Dr. Newman's nipple ointment used x 7 days with no results.
Babes off the breast x 5 days per mom's request with Mother pumping with
Medela pump-n-style pump.  Pain continues with pumping at a 5-6 pain with
babies latch is a 6-7 on pain scale of 10. Mother reports edema of nipples,
pump placement can be observed 30 minutes after. Continues to rate nipple
pain at a 5-6 on pain scale of 10. This same mother states that this is
more pain than the cracked nipples experienced on day 3 postpartum. Mother
has continued to pump throughout this lactation period. Does anybody have
any suggesstion? Could this be a latex allergy to pump? Mother is very
determined not to stop lactation. Babies are 6 wks now. Can anyone offer
suggesstions? Thanks

Sara Macy, RN,I.B.C.L.C

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