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Subject:
From:
Jennifer tieman <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 22 Mar 2005 22:40:50 -0500
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I have a mom with a puzzling skin rash, and am hoping someone will have an
idea.  I told the mom I would bring the question to the wise ones, so I hope
someone has an idea!
This mom birthed her second child on 3/8/05.  Her first was breastfed into
toddlerhood - he was born via cesarean section for breech.  Second baby was
born at 39 1/7 weeks via completely unmedicated VBAC and weighed 8 lbs 1 oz.
 She was put to breast in the first few minutes of life, and has nursed
beautifully.  I saw her on the 6th day of life, and she was gaining well
(not quite to birth weight, but over an ounce a day since hospital
discharge,) and mom was comfortable.  The mom stopped in my office today to
show me her pictures, and mentioned that in the last 2 days she has
developed some itchy red spots on her breasts, about 1/2 - 1 inch outside
the areola.  Baby has no evidence of thrush per mom (I didn't see the baby
today) and had no evidence at our last visit.  Mom says the spots just
appeared, and itch more when baby is nursing, even though her face doesn't
usually touch the area. Her nipples do not itch, although she describes the
left one as briefly tender as baby latches.  On a quick exam, the nipples
look undamaged, a little bit pink maybe, but mom is quite fair, so hard to
tell.  Along the areola in the outside lower quadrant are some small red
dots, not raised.  There are none on the areola itself, just on the skin
outside.  Baby was not available to demonstrate latch, but mom says she has
no pain except brief nipple tenderness on left with initial latch, and
nipple comes out of baby's mouth shaped normally.  Baby has had nothing in
her mouth other than the breast or her own hand - no bottles, pacifiers,
other foods.  There are no new contacts such as soaps, lotions, baby
products, detergents, etc.  She reports no significant engorgement, and says
baby nurses quite frequently, and her breasts generally feel soft and
comfortable.  She describes mild engorgement shortly after discharge from
hospital, and feeling a little lumpy for a few days, but that this is now
gone.
This is not a huge problem now, but we are both curious as to what these
itchy dots could be.  She is otherwise feeling great, and looks healthy and
glowing.  Any ideas?
Jennifer Tieman
Family Physician
Mom to 4, including my toddler nursling Caroline Rose

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