Hello all,
I've just been visited by a mother of a 2-week-old thriving baby who is 
exclusively breastfeeding.  She came in due to sore nipples and cracking at 
the nipple tips bilaterally.  Baby's oral exam appeared WNL, no palate or 
tongue issues and no oral thrush.  When baby latched, he had a deep 
asymmetric latch but every time either his top or bottom lip was sucked in.  
We corrected this.

Mother's nipples were both a little pink and sore looking but the cracks did not 
look infected.  My question is regarding a lesion that she had on her left 
breast, about 1/2 cm above the areola border at the 1:00 position.  It was 
bright red and soft, about 8mm diameter, mom states it is painless unless she 
rubs it hard, and appeared to have a white center as if pus or milk-filled.  This 
was on the surface only, no deeper palpable mass.  It actually appeared 
somewhat like a pimple but it seemed more 'spread out'...larger diameter and 
flatter, and soft to the touch.  

I instructed mom to apply warm moist packs TID-QID, call me if redness 
spreads to surrounding skin, or if s/s mastitis.  It seems that this is almost 
certainly related to breastfeeding and/or nipple damage...any ideas as to what 
this is?

Thank you,
Julie Conaway, RN

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