The next time her nipples are burning suggest that she try dry heat on the nipples like a heating pad over her clothing. If this reduces the burning sensation then there is a good possibility that her symptoms are circulatory and due to vasospasm. Also the next time they are burning ask her to check the color of the nipples. If the baby has a clampy latch then vasospasms are also likely. If the heat relieves the pain then suggest that she use it after every feeding for a few days and she may be able to crack through this. I have worked with many moms who assumed they had resistant yeast when what they were really struggling with was vasospasms. This does not sound bacterial so I don't think antibiotics would be helpful and if there is a yeast component to this I think antibiotics might even be harmful.
Kathy Lilleskov RN IBCLC
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