Dear Helen:

Have you observed the baby breastfeeding to check on the latch? The fact
that the same pattern showed up on the other breast seems to suggest
some sort of abrasion.  Are the baby's teeth suddenly a factor?  (Some
babies take *forever* to get a tooth, but some seem to suddenly sprout a
whole bottom row.)  The mother might have always had abundant milk and
coasted along with a less-than optimal latch. With teeth there instead
of the gum ridge, it might make a big difference if the baby is sliding
down to a shallow latch (and wiggling and looking around like older
babies do) and tongue isn't staying down and forward through the whole
feeding, or the lower lip gets sucked in.  The mother can't always see
what the lower lip is doing, particularly if the baby more in a
sitting-up position (the better to look around).  But having that lower
lip tucked in instead of flanged out can cause sort of a crescent-shaped
rawness at the base of the nipple.

Perhaps Lansinoh to keep the scab from forming might help with the
healing while she works on the latch.  It might also be worth looking
into the moist wound dressings about which there have been some recent
posts.
Changing positions, perhaps even with the mother laying down, with the
baby's feet extending up past her head, might provide some relief.
(Older babies aren't always that agreeable about innovative positions,
though).

Good luck on the detective work.  Pat Gima's post on the thrush
possibility was interesting, relating how she often sees such "slice"
wounds in affected nipples. A few questions -- does the yeast stay
localized in the open wound, or spread to the ducts or across the
surface to more generalized soreness?  Would something like "moist wound
healing" methods provide moisture that might actually encourage
yeast?

Margaret Wills
LLLL

             ***********************************************
The LACTNET mailing list is powered by L-Soft's renowned
LISTSERV(R) list management software together with L-Soft's LSMTP(TM)
mailer for lightning fast mail delivery. For more information, go to:
http://www.lsoft.com/LISTSERV-powered.html