Dear Paula,
       You wrote that a mom with badly damaged nipples still had some pain
after correcting positioning and latch.  You were wondering if the pain was the
result of oncoming mastitis.
       I think the mastitis certainly affected her pain level.  But I
frequently find that moms who have badly damaged nipples, while their pain is a lot
less after correction in technique, still experience some pain.  After all, the
nipples are still wounded.  The correction means that the baby is not
continuing to wound the nipple while at breast, but the damage still needs time to
heal.  Fortunately, new mothers' bodies are in a "high-healing" mode, and if
baby stops repeatedly damaging the nipples at each feeding, moms usually report
that they feel much better in 24-48 hours.
       I am not disputing that mom had mastitis, or in any way trying to
suggest that she did not need antiobiotics.  The damaged skin is much more likely
to allow germs in, and she could very easily have gotten mastitis as a result
of the wounds.  I'm just pointing out that the damage also needed time to
heal.
       Dee Kassing, BS, MLS, IBCLC
       Collinsville, Illinois, in central USA

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