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Fri, 18 Apr 2014 07:46:42 -0400 |
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PTP: Mother reports her 10 mo old, exclusively BF baby, bit her 6 weeks ago. She noticed a small crack then at 12:00 at the base of her R nipple. (I have a couple of good photos with PTP which I will try to post to the Lactnet Face Book page, if that doesn't work, email me privately.) As the wound got larger with continued Bf & pumping (she works 3 days/wk) BF became excruciating. Baby does not take a bottle well at day care (usually only takes one feed at day care & then does marathon nursings with mother.) Baby weighs 19# & is on the 37th% on growth chart for weight. A few wks ago she started using APNO & felt it helped a bit with the pain (now just barely tolerable to nurse) but no change in size or signs of healing. She is determined to BF for a full yr (2 more mos) & is desperate for ideas to get there. I can think of many ideas for topical treatment (Medi-honey, peppermint gel, virgin coconut oil, etc) but how can she keep the wound edges approximated to allow healing? Here were my suggestions:
1. See her HCP ASAP for assessment & possible antibiotics as she may have a bacterial infection
2. Pump exclusively on that side with a different size flange (larger? smaller?) & see if the wound does not gape open further while pumping. She is reluctant to do this as baby does not take a bottle well, he just loves to nurse. She has experimented with a cup & I suggested using a cup more often.
3. Try a nipple shield? Sized to prevent further widening of the wound.
4. Use Op-site to try & cover & keep the wound edges approximated while pumping. Can’t try this while nursing as baby’s mouth would cover the area.
5. Wean from that breast & continue to nurse on (L). Mother states she doesn't think she could produce enough for baby.
Oh wise ones...other ideas??
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