I have a pt. in our NICU who is exclusively pumping. Initially her flanges were the wrong size and she had some small lacerations from that. Those are healed and there are no other signs of trauma. At two weeks she started complaining of burning in the nipples and areolas bilaterally. She tried APNO but said it burned so we had her d/c that. She used Gentian Violet X 1 week with no relief at all. Her doc prescribed Diflucan, but only 2 150 mg doses.
But between the Diflucan and GV I would have expected some relief. She reported none. Her doctor prescribed antibiotics and she is on day 4 of those and the burning is getting worse. She is wearing shells for sore nipples because she can't stand to have anything touching her nipples. 

I have done a lit search and there was one article that mentioned the possibility of eczema. I have recommended she be seen by a dermatologist because I'm not hearing anything that has me convinced in one direction.

Any thoughts?

Andrea Tran RN, IBCLC
Boulder/Erie, Colorado

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