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Subject:
From:
Karen Querna <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Tue, 13 Sep 2005 09:00:12 -0700
Content-Type:
text/plain
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text/plain (128 lines)
Dear Traci
The issue here is you have wounds that have not healed. The baby is 
gaining well - I do not see latch/nipple as the issue. The Plumbing works.
My First Rule:
Healthy Skin Heals Quickly-lanolin sooths, can create a moist wound 
healing environment  but in my perspective if a sore nipple is not 
better at 3 days, improving by 5 days and healed by about 7 days  the 
nipple is infected not sore (especially with a baby that is gaining 
well) a  women with unhealed nipple wounds at 4 weeks has an infected 
wound - what a wonderful place for bacteria to proliferate- they are in 
7th heaven.

She needs to:
1. Get a scrip from her HCP for an anti-bacterial cream or the 3 part 
Dr. Newman Recipe, Stop the Lanonlin-
2. To keep the Medicine on her nipples and not on her nursing pads she 
should wear hard shells with lots of holes
3. Its okay to was the nipples with a soap and water (if you have a 
wound on your hand you would be washing it with soap an water to keep clean)
4. This woman is lucky she has not had Mastitis yet (Usually this 
happens at 5pm on a Friday)- please teach to here the signs and symptoms 
and treatment - Yellow could mean those little Staph Bugs are getting 
even more hungry and proliferating even more -
5. Give this Woman a BIG hug (not chest to chest until she is healed)
Good luck
Karen Querna, RN, BSN, IBCLC
Spokane WA

>
>Date:    Tue, 13 Sep 2005 08:24:29 -0700
>From:    Traci Mills <[log in to unmask]>
>Subject: new here - need suggestions (long)
>
>Hello All!
>
>My name is Traci and I have been an LC for 5 years. I
>have just recently started a private practice in
>Wichita Falls, Tx. 
>
>I have a client that has serious ulcers on both
>nipples, and has given permission for me to post to
>the group. Her nipples look like mirror images of each
>other. The ulcer on the right side is at the 11:00
>position, and the one on the left side is at the 1:00
>position. Baby is 4 weeks old, and a little barracuda.
>His bottom lip flanges, but I cannot see the tongue,
>and his top lip tends to roll under and mom will pull
>it out.
>
>The left nipple is healing slowly. The ulcerated area
>is bright red and the new tissue looks very healthy.
>The right side is a yellowish color. This one
>developed just in the last few days.
>
>She also has deep fissures across each niple. 
>
>I observed several attempts at nursing. Mom has good
>positioning, baby has very audible swallow, and is
>very alert. White compression stripe is apparent when
>baby lets go of nipple.
>
>As I looked at mom's nipples, something just didn't
>seem right to me. Her areolas seem way to round, like
>the end of a watermelon. She has a tiny stump of a
>nipple, and stated she's never had "perky" nipples
>like you'd see on models. So, I am suspecting flat
>nipples, and baby has pulled them out a little from
>nursing. Mom said no one ever looked at her nipples at
>any time.
>
>Baby is gaining weight, (7.1 at birth, now 9 lbs). Mom
>leaks lots of milk, but she is in so much pain she's
>ready to give up. So far she's still 110% committed to
>breastfeeding.
>
>She's using Lansinoh, and has just purchased a nipple
>shell she began using yesterday. I showed her
>different positions, but all are painful. I suggested
>she pump after feedings and cup feed baby when he
>first wakes to stave off hunger so she can take some
>time getting him positioned. He seems to sleep through
>early hunger cues. I am open to any suggestions to
>tell mom how to nurse comfortably. Of course, pain and
>injured nipples are first concern.
>
>Thank you so much for any sugestions.
>
>Traci Roberts Mills
>MotherNurture Lactation Services
>
>
>		
>__________________________________ 
>Yahoo! Mail - PC Magazine Editors' Choice 2005 
>http://mail.yahoo.com
>
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>End of LACTNET Digest - 12 Sep 2005 to 13 Sep 2005 - Special issue (#2005-180)
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