Hi All
I have a client, 19 years old, first baby is one month old with
excellent and steady weight gain. Mom has abundant (excess?) milk supply -
has been able to pump plenty for her return to work. I saw this mom for her
first PP home visit, and she has seen another LC for four visits. I saw her
again on Sunday.
Now, the bugaboo is her nipple tips. The left is not as severely
abraided as the right, but each nipple tip has an area (1/2-1 cm diameter on
the left, about 1.5 cm diameter on the right) of raw-ness, pink and yellow
in appearance. Pain is intense with latch or touch, but only then. Mom
reports the area did scab over, but she removed the scab. (?) No c/o
burning pain. No s/sx thrush or yeast in mom or baby.
Over the weekend, mom had what she called mastitis, but what we together
determined was more likely clogged ducts. She self-selected to use cabbage
leaves for a few days, which she reported as being very helpful as the area
around her nipples was kept moist. I suggested to her that long term use of
cabbage leaves could decrease her milk supply, so that she could use other
forms of moist healing, ie lanolin, to aid healing.
So, my fellow LC did a f/u call today, and mom reports the pain and raw
areas are worse. :( She wants to continue bf, but is getting weary of the
pain, understandably.
Ideas I have would be to treat for yeast, just in case, as well as to
try Dr. Jack's nipple ointment.
We *did* review latch, getting baby to open his mouth wider to get in a
nice mouthful of breast, techniques to get the nipple back farther into
babe's mouth, varying nursing positions, not allowing the baby to nipple
feed, etc.
What additional ideas do you wise folks have? What have I missed? (BTW
this mom lives at home with her family and has excellent social support.)
Thanks in Advance, and now off to the archives as well,
Ann Marie
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