Hello again,

Just an update and thanks to those of you who responded to my query for a 
mom with persistent soreness after complete and varied treatment for thrush. 
She did try maalox on her nipples and found it to be soothing for a brief 
time but then the searing pain returned and the nipples remained quite red.

She became so sore that one suggestion was to pump to give her nipples a 
break. Not only did that help, she noted that after 3 days her nipples 
weren't as sore and scalded looking and felt sooooo much better. Someone had 
suggested she try a shield, which she did. She said if nursing pain score 
was 100, nursing with a shield was only about 15 and very tolerable. So she 
will try to use the shield for a few days at see if her nipples remain 
improved. She is anxioulsy awaiting her visit to a dermatologist in a week.

So I'm still back to what would cause such extreme redness. The digital oral 
exam on this baby again seemed very normal despite a bubble palate and the 
baby gapes wide and seems to have no jaw clench. Compression of the nipple 
is not noted after feeding. It sure looks like a chemical burn.

I do not think it is a tongue tie of any kind, but I'm only 80- 90% certain 
of that. I have been suspecting for some time, that some babies must have a 
variation in their saliva that causes nipple pain and a scalded skin 
appearance, looking an awful lot like yeast and yet it is apparently not.

I wonder if a culture of the babies oropharynx would ever give us info on 
strep or staph growth. I'd also love to see a study on the ph levels of 
saliva in babies that are diagnosed with reflux versus those who
are not  and see how those levels correlate to nipple soreness in mothers.

Maybe I am way off base here (I''ve been told I " think to much") but I have 
seen way to much recurrent yeast, and I wonder if we are really missing an 
entire other entity.

LuAnn Smith RN, BSN, IBCLC
York, PA

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