In relation to the thread on severe nipple breakdown, I recently had a mom
pumping for a premie at home, who had spoken to another LC and a doctor
about her sore nipples. She described the skin flaking off in little chunks
and leaving raw skin underneath. She had moderate pain but no burning or
itching or thrush s/s in baby. She was advised on the use of lanolin,
expressed milk on nipples, and review of pump use, flange size, lubricating
the flange, and the like. She was using the largest flange size for her
pump, the Elite. We even talked about vegetable oil to lubricate the
thickened skin and help it flake off.
She was coming to the area, and so I asked her to stop and I would let her
try gel pads, and take a look myself at the nipples.
They were quite red, with irregular plaques of beige skin on the surface,
but I noticed below the Rt nipple there was a pustule. We called the dr. who
prescribed oral antibiotics by phone. A couple days later she called to
complain of a red tender lump in the areola, near her LEFT nipple, about the
size of a US nickel coin. I referred her to her dr. for evaluation of
probable mastitis and potential abscess. No fever or headache or achiness.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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