>if they are at the base of the nipple, making the nipple
look as if it is going to detach then thrush<

Pat I also find these are signs of under the arm/ football holds where the
neck gets ever so slightly flexed, nose gets tilted in and chin away, so
pressure is on the underside, although attachement looks OK to the mother.
All because baby is a little too far forward and flexion brings him closer,
but at an angle. Can also happen when baby is across lap in cradle hold but
body away from mother's body: fissures tend to be side-bottom of nipple.
Saw this a lot in Nigeria because in that hot sticky climate mothers tried
very hard to keep babies away from contact with their sweaty bodies when
breastfeeding. Swing baby's bottom in, keeping head/neck angle OK, and
angle of chin to breast is dramatically different. what's the usual hold in
Brazil?

Treatment severe fissure:
1. position position position
2. Lansinoh
3. holding edges together between feeds. I've used non-allergenic tape,
steri-skin, anything to hold the thing together so that between feeds it
has a chance to heal. The less adhesive the better of course, as it has to
come off usually for feeds. But healing is so rapid that it isn't a big
problem. End all other creams and potions in use as dermatitis doesn't
help.

If thrush is suspected then I add gentian v before Lansinoh (rememer,
aqueous .05%) once to see if it helps: should reduce inflammation
dramtically if thrush is the problem. Wound won't heal while thrush is
present.  M

Maureen Minchin, IBCLC. Christ Church Vicarage, 14 Acland St., St.Kilda,
Vic. 3182 Australia. tel/fax: 61 3 9537 2640
"Taking paths of least resistance is what makes rivers - and people -
crooked." poster in Palmerston North NZ bookshop...