THis is a heads up.... I just had my first experience with MRSA on a nipple wound. All of the normal things we tried to heal it just didnt work so I sent her back to her physician and it was cultured and came back MRSA from the exudate on the nipple. Our ER physician told us that over 80% of all of the abscesses they see in the ER are now community aquired MRSA. Just one more thing to keep tucked back in our minds.
Susan Gehrman RN, IBCLC, CCE
Battle Creek Health System
300 North Ave.
Battle Creek, Michigan 49016
"The world may not honor your honorable intentions, but you should have them anyway" Mother Theresa
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>>> "Julie Conaway" <[log in to unmask]> 8/9/2007 2:01 PM >>>
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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