Hi Jessica,
There is precedence in the literature for stopping the thrush
treatments due to no improvement in all this time. Culture nipple
wound(s) and begin treatment for probable staph infection. The signs
and symptoms (s/s) can be similar to thrush. And especially since the
original cracking has never healed.
I would suggest she stop stop the thrush med on the baby (or finish
what little is left). I would suggest she stop all topical
applications to nipple. I would ask mother to gently wash nipple
wounds with mild soap and warm water (her hands should always be
scrupulously clean when handling wounds) several times a day and pat
dry with clean cloth. She can be treated topically with antibacterial
ointment but will need systemic (by mouth) antibiotics for staph.
The Raynauds' s/s should resolve as the infection gets treated. Very
gentle warmth could be used if needed. If she pumps, clean and
sterilize the pump parts. Counsel her about s/s mastitis to report
immediately.
She might have to revisit the tongue-tie release to see if it needs
revision, as some do.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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