The following is a message I received from a friend which I was hoping to receive guidance on. 


"Exactly 2 weeks ago while nursing my 20 month old and sleeping she bit me so hard. Harder than ever, I was crying for hours. I suspect she was falling asleep and my nipple started to slip out before she was ready and she bit down, hard. There was blood everywhere. I cleaned it out with hydrogen peroxide and put Neosporin and gauze pads on it. The only way I could get the pain to subside was with a warm compress. I definitely did not nurse with the Neosporin cream on. And I only used it for the first two days of healing. In addition I did lots of warm sea salt water compresses and soaks and let it get as much air time as possible. But it was bleeding for quite a few days before it scabbed up. I was NOT nursing on this side for about a week. I hand expressed just for relief in the shower and did lots of massage on my clogged ducts. I did not notice a difference in color. No bruising or redness. No fever, just some engorgement. The pain and blood continued for days. We only used the other breast to nurse. About a week ago, a tiny bit of the top scabbed up and came off in the shower. The nipple looks healed but it’s missing a piece of it and I leak milk all the time.

 It just pours out like I've just had a newborn. I was not leaking when the nipple was scabbed, but, when it came off, that's when the leaking started.  So, I feel like we are back on track, nursing again pain free from both sides, but there is a tiny bit of my nipple missing, and that is where I leak. If I have a letdown or not, all it takes is a squeeze the wrong way and I can soak through a shirt. I hoisted my 20 month old up onto my hip and just the pressure her body put on my breast made me leak through my bra and down the front of my shirt. And today, I took a shower and was plucking my eyebrows afterwards. I looked down and I was dripping milk right into the sink. My breast was not full nor had I had a letdown in either situation. It is just so weird and I don't know what to do. Just for frame of reference I have not needed to use breast pads for over a year and I never leak when I have a letdown.

I breastfeed 4 quick times a day and do lots of night nursing because we co sleep. "



Does a wound of this nature require any special type of care? What exactly is happening here? Any thoughts, suggestions, information or resources are very much appreciated.  Particularly about how to best manage the leaking, the amount of time she can expect to wait before the nipple heals or anything that will speed healing, or anything she should avoid as far as nursing?  Should she follow up with an LC in person or another healthcare provider? She lives in South Carolina so I cannot visit her. Thank you for your time.

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