I have a problem and need some help.I have been visiting a mother who is now 3 weeks post c/section.On about
the 4th day she developed a red inflamed area on the breast , fever etc. I treated this with Flucloxacillin
for 5 days and the symptoms settled. She was left with a bruised looking area that has gradually faded. At the
same time as starting the Ab's I treated her for yeast as she always has a problem with this after Ab's. All
this time she was feeding frequently on the affected side and expressing if the baby didn't seem to have
emptied the breast to her comfort.There was no nipple trauma.With the infection she started to have some
shooting pains in the breast after feeds which I assumed was a yeast problem and made sure she continues
treatment for this with the miconazole nitrate 2% that I gave her.The problem is that she still has intense
pain with the baby's first suck and then a painless feed but has shooting pains after the feed for about 20
mins some radiating from her shoulder blade. After about 20 mins all is well but the breast is very itchy.This
sounds like yeast to me but what am I missing? I know that gentian violet has been mentioned but it is not
available to us here.Suggestions please shes getting a bit desperate> She also lives an hour and a half away
so I do not see her more than once a week but have long conversations. I saw the breast yesterday and it looks
normal with no obvious trauma.
Thanks for any help you can give
Judi Murphy...Community midwife and LC
Gisborne , NZ