PTP

A mom of a 3 1/2 week old baby boy is having nipple pain that she says is
often worse in between feedings.  She has described the pain as comparable
to a bad sunburn on her nipples and says that it hurts when anything
touches them (clothes, shower water, baby's mouth, etc.).  Her nipples show
signs of possible vasospasm (turning white after a feeding), but are not
soothed with warmth (possibly because it hurts to touch them).  She has
tried Newman's APNO, but it has not relieved her pain.  Mom has a history
of eczema and is allergic to lanolin, so she has used only lanolin-free
nipple creams (including motherlove and bamboobies brands), but none have
provided relief.  She has also tried breastmilk on her nipples and seems to
find this somewhat helpful.
Baby's latch looks good, but mom complains of baby clamping.
Baby had a posterior tongue tie successfully clipped around one week of age.
Mom's labor was unmedicated, but long due to baby's posterior positioning.
 Mom took ibuprofen as needed post-partum, but no other medications.  Mom
says that nipple pain increased when she stopped taking the ibuprofen.
Baby is gaining well and has plenty of wet  and dirty diapers.  Baby
currently has a diaper rash that pediatrician thinks is a bacterial
infection and seems to be responding well to treatment with neosporin.

Any thoughts on how to help this mom would be greatly appreciated.

-Máire Prabhakar

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