Hi, I'm new again to the Lactnet after several years, and am writing with a situation with a mother that I haven't run across before.

My name is Rebekah Kirwan.  I'm in northern California.  I'm a CLE and IBCLC exam candidate this year.  I work with WIC moms and have also been an LLL Leader for several years.

I've been working with a mom who's been struggling with a bad case of thrush.  Because of limitations in the mom's insurance (she has only Medi-Cal, and that is only for limited maternity/family planning coverage), and a less-than-ideal response from the HCP that she is able to go to, we've had a difficult time getting appropriate care for her.

She has the worst case of thrush that I have ever personally seen, with extreme, almost unbearable itching, severe, burning pain, and what are apparently thrush fissures (with bleeding and skin peeling off.)  This mother is truly dedicated to breastfeeding her baby, and overcame significant breastfeeding obstacles eveb before the onset of thrush.  (Her baby is now 2 1/2 months old.)

The HCP prescribed Clotrimazole cream for the mother's nipples, but nothing for the baby (who has no symptoms.)  After several days, this had not helped, and the HCP's office was closed for a long weekend that included a staff training day.

Because she could not reach the HCP over the weekend, the mother used gentian violet for 4 days, in conjunction with other management methods she had already been using (such as airing her nipples, boiling breast pump parts, pacifiers, etc, on a daily basis, and so forth).  This improved the situation -- she was able to nurse baby at the breast for the first time in several days -- but did not eliminate the problem.  When the HCP office reopened, she was told to continue using the Clotrimazole cream and call back if the problem had not resolved in 2-3 weeks.  After one day with no gentian violet or other therapy, she used the gentian violet one more time (a total of 5 uses in 6 days.)

We are currently waiting for the mother to get an appt. at the local health clinic through public health nursing.

When I talked to the mother yesterday, she told me that her breasts are becoming numb after each time she feeds the baby.  She says that when she pinches the skin on her breast at this time, she cannot feel the pinch.  She tells me that the numbness feels like it is just on the surface (in the skin) and not deeper in the breast.

Has anyone ever encountered numbness like this before?  Could it be related to the thrush?  Could the gentian violet be causing it?

This mother is an older teenager.

Thank you for your help!

Rebekah Kirwan

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