I am working with a mom here at our hospital who is in preterm labor and really wants to be able to breastfeed.. She has had a problem for 12 years now with nipples that are continually excoriated - they crust and scab up on the nipple tips - it actually looks like the scabbing occurs on the nipple ducts. She tells me that once these scabs have formed, they fall off and are excruciatingly painful, leaving her nipple tips raw.  The base of her nipple is also effected, with cracks continually forming.

This mother to be is 32 weeks pregnant, and may be delivering soon. She desparately wants to breasteed, and is afraid she will not be able to due to this chronic skin problem. She has a history of mild dermatitis on other areas of her body, but at this time she is asymptomatic.

I am going to suggest that the nipples be cultured while she is here at the hospital. If anyone has ever seen this in their practise, I would sure appreciate hearing from you. 

Thanks,
Brenda Phipps, BS, IBCLC

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