Hi everyone!  It seems as though all of my patients in the last few weeks have
been complaining of severe breast pain, in babies that have nursed for about 6
weeks.  One mom had poor positioning and that helped improve the situation but
she still reports pain.  Doesn't want to come back for a second visit though.
My most perplexing mom is a mom that delivered at 36 weeks, baby gained well
for the first month then started losing.  Mom only pumps about 2 ounces total
now and 1 breast much more than the other.  Has reported severe pain with
nursing and for about 5 minutes after all through the breast and between
breasts.  Ob treated with diclox for 7 days and no improvement then Keflex for
7 days and no improvement.  Mom came in and I finally saw her baby had diaper
rash not responding to otc treatment and it looked like yeast so started the
yeast procedures and treated mom with Diflucan.  Mom thought at first she was
better but then reported the same pain.  Mom called back a few days later and
said baby had "cancer sore like blisters in mouth"  think it is thrush and
retreated with Diflucan and Nystatin for mom and baby.  Mom also asked about
milk cultures  so we did them.    the left breast that produces the most milk
grew out staph not aureus and rare alpha strep.  The right grew the same plus
rare diphtheroid like gram positive bacilli so on the advice of peds started
on clindamyacin.  I need as much help and adivce as possible asap.  What is
the next step and why so much breast pain in my patients all of the sudden??
Any other etiologies you wise ones can think of??  Babies are not tongue tied
and palates feel normal.

TIA

Toni Myers Rn, IBCLC