Dear list members,
I have been a Lactnet "lurker" since getting my IBCLC in July 1999 and have learned a great deal from reading the postings.  I had a mom (permission granted to discuss the case) today who has severe nipple burning while her 1 month old son nurses.  The latch looks very good, flared lips, tongue over lower gum, suck swallow pause etc.  No nipple distortion after feeding or change in nipple color (which is a light pink).  Mom is a LaLeche League leader and very knowledgeable.  Baby is thriving. This mom had severe nipple pain when nursing her first child (4 years old).  It was finally diagnosed as nipple vasospasm (nipple blanched after feeds) by a Lactation consultatnt. She continued to nurse her 4 year old during pregnancy in hopes of avoiding such severe nipple pain with her new baby but immediately post partum her nipple pain returned.  She has tried several thrush remedies, including a course of Diflucan for 21 days.  She has had no relief of her pain during the treatment and now has deep breast "stabbing, shooting" pains which are unrealted to feeding times.  Dr Newmans APNO has lessened the nipple burning just a little.  Mom does not want to take niphedipine.  I've read the archives on nipple vasospasm and deep breast pain.  they seem to suggest a connection between staph aureas and these combined symptoms.  I'm also thinking about duct refilling pain as a possible cause. This is a committed breastfeeding mom who is reluctant to use medications but wants to finally enjoy nursing her child. Suggestions please? 
Sorry the post is so long
Gale Denis IBCLC RNC

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