This mother feels cheated re her breastfeeding experience - I would
appreciate any thoughts and help.

Baby is 9 months old.  I saw parents and baby for the first time this week
(they live 2 hours away).  Waterbirth at term, weight and milestones all
within normal limits.  Stay-at-home mother.   Maternal grandmother has
breastfed 10 children for about 4 years each!  Mother depressed during
pregnancy.  Took antidepressant from 3 to 6 months postpartum.

Cracked and painful nipples since birth.  Slow start, baby sleepy, drinking
poorly with shallow latch.   Initiated formula then goats milk at 3 months
because of persistent breast and nipple pain and what appears to be
Raynaud-like symptoms. Pumping also painful.  Breastfeeding 2x daily now.

Treated for thrush at some point - stat dose flucobazole and daktarin gel -
although treatment might have been inadequate, there was no improvement.
Used gentian violet for 3 days (baby and nipples) with no improvement in
pain.  Also tried homeopathic remedy for candida.

Saw LC last week who found a very attached tongue.  

Mother is now happily 5 weeks pregnant.  I noted that her right breast is
involuting as not being used much due to pain. Left breast producing well.
Nipples very slightly pink. Do not appear misshapen or grazed.  Baby was too
distracted to feed well. Tongue behind gum line at latch - lips
well-flanged.  Did not suck long enough to initiate MER.  Mother's latch
technique good.  Mother states she does not really feel "pulling" during
breastfeeds.  Feeding is very painful and an "adrenaline rush". 

What is going on?  Mother will consider clipping of frenulum - will it
improve latch at this stage?  Are we really dealing with ductal thrush?
Should 6 to 8 weeks of antibiotic treatment be considered (as per Dr Anne
Eglash's recent message)?  I am not familiar with Delgado's work - have not
been able to find it either.  What about the new pregnancy?

Thank you.
Jean Ridler  RN  RM  IBCLC
Cape Town
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