Sorry for the late reply. I have found the protocols for nipple pain from UNC helpful.
https://www.mombaby.org/wp-content/uploads/2016/04/PainProtocols.v3.pdf
Take care,
Amy
Amy Wagner, BS, RN, CCES, IBCLC
Hershey PA
Sent from my iPad
> On Jun 27, 2017, at 7:50 AM, Nikki Lee <[log in to unmask]> wrote:
>
> *Hey All - I have a mom who reached out to me and is having her 3rd baby.
> She struggles with odd nipple pain almost immediately after delivery, but
> it does not present as vasospasm. I said I could reach out far and wide and
> see if my colleagues have any comments or suggestions. Pain does not occur
> with pumping. If anyone is on lactnet, please post for me, tell me what
> bounces back. I asked her for her history to share, here it is:*
>
> *Patient A:*
>
> Nipple/breast pain history:
> 2012- had child 1, fed at breast in hospital, day 2 needed to pump because
> engorged. Went home and had to pump first then feed baby due to too fast
> letdown. After day 4 called LC because feeding felt like glass was being
> pulled from nipples during latch on, off and during. Was treated with 30
> days diflucan. Would try again and within one day pain was back.
> Ended up just pumping for a year and bottle feeding. Tried throughout that
> time again and would immediately get itchy breast tissue and sore nipples
> again.
>
> 2014- baby 2. Fed at breast upon birth and within hours areola was swollen,
> hot, painful to touch. Too painful to feed. Started on pump. Tried salt
> soaks, sunlight and air. No help. Triple nipple cream never helped. Treated
> with diflucan again, no help and went to pumping for 9 months.
>
> 2017- baby 3 arrives in Sept. as of right now I have sore nipples when a
> shirt or towel brushes them. No breast pain. Nipples have a little white on
> tips that can almost be picked off. When in wet bathing suit breast tissue
> becomes itchy for a few hours.
>
> Health History:
>
> Surgeries-
> Two c sections
> Tonsillectomy
> Nasal/sinus surgery
> Gallbladder out
>
> Overweight, but good health. No diabetes, no high bp, normal cholesterol.
> Seasonal allergies; Allergic to:
> Sulfa; Latex (lanolin is derivative), get itchy skin.
>
> Skin history- sensitive skin. Prone to yeast on c section incision. Can get
> Eczema in winter.
>
> Gyn history:
> Regular periods, on pill for 10 yrs, 3 miscarriages, 2 healthy children.
> Expecting 3rd. One sexual partner. Was strep positive at time of second
> birth.
>
> Donna Sinnott, BBA, IBCLC
> www.peacelovebreastfeeding.com
>
> --
> Nikki Lee RN, BSN, Mother of 2, MS, IBCLC, CCE, CIMI, ANLC, CKC
> Reviews Editor,* Clinical Lactation*
> www.nikkileehealth.com
> https://www.facebook.com/nikkileehealth
> *Communications are confidential and meant only for whom they are
> addressed.*
>
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