Hi, wise colleagues,

I have been working with a wonderful mother for the past nine months 
and we have not been able to relieve her symptoms of nipple 
pain.  She took the time to write out her situation and has given me 
permission to post it here for your ideas and input:

>Hi Diana,
>Here is the story of my nipples. . . .
>
>I have had pain since the day I came home from the hospital. My baby 
>was tongue tied and my nipples were bleeding for a few days. 
>Benjamin had his tongue clipped two times and my piercing pain upon 
>initial latch improved significantly after the second 
>clipping.  [Diana's note:  posterior tt]  Within a month the pain 
>associated with the clipping was gone; however, my nipples still 
>hurt. Since this time, the pain has remained the same. I have 
>constant "raw" nipples. I cannot touch them, I cannot let water in 
>the shower spray directly on my nipples, I have to pat dry with a 
>towel and I cannot sleep on my stomach or let anything ever touch my 
>nipples. If I do not touch them there is usually not any pain.
>
>In additon to this pain, my nipples also turn white and then bluish 
>frequently. I have not noticed an increase in pain when the color changes.
>
>This exact pain also occurred with my first child who I exclusivlely 
>pumped for (she never nursed) as well as for my second child who did 
>not have any nursing difficulties. The pain was gone approximately 2 
>months after I stopped nursing baby #2 at 14 months of age. I tried 
>to work with several different lactation consultants and midwives to 
>try and resolve my nipple pain with my first two children and was 
>unsuccessful. I changed flange sizes and trialed diflucan for 2 
>weeks with no improvement. With baby #3 I have recently tried the 
>following rx and supplements for 3 1/2 weeks without any change in my pain:
>30 mg of Nifedipine daily
>Mupirocin 2% ointment 3 x per day
>5000 MCG Vit B12 daily
>4000 IU Vit D daily
>500 mg L-Carnitine daily
>600 mg Alpha Lipoic Acid daily
>
>Baby #3 is now 9 months old and really enjoys nursing, as do I. My 
>nipples still continue to hurt quite a bit and I would love to 
>figure out what is causing my pain.
>
>Thank you, thank you, thank you!
>
>Cindy

My feeling is that it is vasospasm -- I do not see any 
characteristics of staph or yeast -- but she is not responding to the 
standard treatments.  She didn't mention it, but we have also tried 
over-the-counter antifungals, with no improvement.

Thank you for any ideas you may have.



----------
Diana West, BA, IBCLC
International Board Certified Lactation Consultant
Mahala Lactation and Perinatal Services, LLC
Hackettstown, NJ
(908) 400-1820
http://www.mahalamom.com

<http://www.facebook.com/MahalaLactation>
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