I need words of wisdom for helping a mother of an 8 week old baby.  This baby
was born at 36 weeks on December 22.  Very medicated birth.  Would not latch at
all.  Parents pumped and cup and finger fed for two weeks, then when he still
refused to nurse, began bottles.  Mother purchased double electric pump and has
been pumping most of his milk.  Continued to offer breast but no latch.  Baby
finally began nursing one week ago, and mother is thrilled, but here is the pain
history she has had.

Breast pains, shooting, for about 5 years, way before baby or pregnancy.
Slightly worse in pregnancy.  When pumping began she complained of severe pain.
So I felt it was a possible yeast red flag.  Mom used yeast treatments, and also
Nystatin, which did not help.  Pain continued during pumping.  During pumping
feels a hot and itchy feeling under the skin of her breasts.  After pumping (and
now nursing), she feels severe pains in the breast, and sharp pressure, which
lasts 15 minutes.  Tried gentian viotet last week, which she felt made pain
worse.  Feels pain is worse now that baby is nursing at last.  Now has sore
nipples as well due to improper latch, which I showed her how to correct today.
Baby likes to nurse directly on nipple and not take areola in mouth, which
explains the sore nipples.  No history of vaginal yeast infections.  MD has been
called several times, says it can't be yeast because there are no white spots on
the nipple, and that the pain is coming because her breasts are heavier with the
milk.  This mother is in severe pain after the nursings. She asked me if I
thought she was just a wimp with low pain tolerance.  I told her No, this pain
was unusual and I was sure it was painful. She said one day last week after
nursing she noticed red streaks in the breasts, but they were gone after a few
hours and she hasn't seen them again.  Breasts look full, nipples light pink in
color with a bit of a pearly shiny look in a circle around areola.

Could this be ductal yeast?  Could it be something else underlying?  We are
going to try correcting the positioning and latch, and cool compresses after
nursings to help, and contacting her physician yet again for a medical solution.
Would diflucan help?  Could a mastitis run this type of course?  No fever, the
redness only once, no particularly sore breast or lumps except during and after
nursing.

TIA,
Ann Calandro, RNC,IBCLC