Hi Wendy,
Just this week there was another post re yeast, but many respondents said it
was probably not yeast. See if you can find those posts, under I think it
was called  'thrush' actually.
Re yeast, I tend to see it after a period of pain-free bf, several weeks or
months, usually. And then mother presents with sore nipples, very red,
burning, usually. Often baby has s/s of thrush in mouth or diaper.
It seems that your client had latch issues from the start. Even though you
said latch wasn't shallow, you indicated there was tension on the nipple,
which needed attention. This leads me to believe that nipples were still
being damaged.
In this case, I would be doubly sure mother knew how to position, latch,
de-latch if needed, and support baby and breast throughout feeding. If
things were not getting better, I would investigate for tongue tie. I agree
she could have a bacterial infection at this point. I generally recommend
cleansing cracked nipples few times a day with mild soap and water and/or
mild soap with saline rinsing. Apply antibiotic ointment to cracked area.
Teach mom to monitor for s/s mastitis. She should see improvement in 48 hrs
or return to you.
Laurie Wheeler MN RN IBCLC
Mississippi USA

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