Dear lactnet friends:
 
I have a question about a mom I saw earlier today.  Her baby is 5 days
old.  Mom describes only brief latches, but has abrasions at the tip of
each nipple.  After a brief attempt to latch babe on mom's flat nipple
today, a 24mm nipple shield was introduced.  This facilitated a more
prolonged latch, but no signs of milk transfer.  When babe came off the
breast, the nipple was bleeding.  Double pumping was initiated, with the
pump on minimum suction.  This was the first time mom had pumped, she
feels her milk started "coming in" earlier today.  Yielded about 45 ml
of transitional milk.  When the flanges were removed, a long string of
mucousy, gel-like milk was attached to the nipple on both breasts.  When
I transferred the pumped milk to a "take-home" container, there were
large (size of  large grapes) clumps, again appeared like gel, from each
breast.  I have read that clumpy milk may indicate the presence of MRSA,
but this mom has no symptoms of mastitis, or nipple infection, although
does have the abrasions at the tip of the nipples.  I gave her a sterile
specimen container, and suggested she bring a sample for culture to her
appointment with her GP, if she continues to see this.  Any idea what
this could be?
 
Thanks in advance,
Doreen Vanderstoep RN, IBCLC

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