LACTNET Archives

Lactation Information and Discussion

LACTNET@COMMUNITY.LSOFT.COM

Options: Use Forum View

Use Monospaced Font
Show Text Part by Default
Show All Mail Headers

Message: [<< First] [< Prev] [Next >] [Last >>]
Topic: [<< First] [< Prev] [Next >] [Last >>]
Author: [<< First] [< Prev] [Next >] [Last >>]

Print Reply
Subject:
From:
Barbara Wilson-Clay <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 25 Nov 2000 11:15:22 -0600
Content-Type:
text/plain
Parts/Attachments:
text/plain (43 lines)
I don't have a lot to add to Jean Cotterman's insightful post about the hole
at the base of the nipple that won't heal, but thought I'd chime in in
agreement that there may be a fistula into a sinus or duct. It might be more
difficult for such a breach into a duct to heal than just penetration into
nipple/areolar tissue.  I wonder if she could visit a plastic surgeon and
just have the wound visualized.  He/she could give an opinion if a small
stitch or two could close the wall.  Right now the lobes 'up river' are
draining thru that hole, and one has to hope the closing of the wall of the
wound could be done in a way that didn't seal off, but would re-canalize
the main pathway. If they can rebuild perforated nasal sinuses (which is
done all the time) then I don't know why this couldn't be surgically
achieved with micro surgical proceedures.  Maybe a really good breast
surgeon would be another option.

I have a lot of experience watching quite severe nipple fissures heal. I've
seen nipple rings removed, large cracks from sucking trauma, etc, and the
tissue typically granulates well and heals up over time even with milk
draining out.  Sometimes a superficial sort of infection prevents the tissue
from knitting.   So one thing that might be wise to try is to coat the
fissure with Bactroban (mupirocin), and to rinse off after nursing so the
surface is kept clean.  The mother may also want to consider a partial,
unilateral wean-down to slow production on the affected breast.

I've got some new photos of a punch biopsy of a nipple to rule out Paget's
disease where the dermatologist took out a 3 mm core of tissue from the
nipple face to examine.  He put a stitch in it, which I was pretty sure
would be more annoying than useful.  Within 2 days the mom persuaded him to
take it out because pumping wouldn't drain the breast and the 7 mo old baby
could.  The sutures bothered the baby.  The nipple is granulating in slowly.
I don't think a suture at the base of the nipple would be as intrusive, and
you could cut the tip off a nipple shield and use the silicone ring to cover
the wound.

Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html

ATOM RSS1 RSS2