In a message dated 97-04-09 01:17:05 EDT, you write:
>Hi Lactnetters,
>I am a new subscriber and a nurse working toward
>IBCLC. Tonight I received a call from a new mom who was in one of my BF
>classes. Keep in mind she happens to be a M.D. Baby is 2 weeks old. BF
>has been going well. Soreness to one breast with pumping. Using Lactina.
>Was inserting the adaptors into the flanges about the time of soreness
>onset. Has since removed inserts from flanges. About that time {or
>after?} developed a lesion at the margain of the areola. States it was
>filled with "either puss or milk." She expressed it. Now lesion is
>filled with serous fluid. Sore with pumping,less sore with feeds. After
>some research and further probing, discovered she had had "cold sore" 5
>days ago. We decided together to contact peditrician, get lesion
>cultured, pump and dump affected side until HSV ruled out. I also
>recommended triple antibiotic ointment to lesion, minimal suction
>setting on pump, warm compresses before pumping, and cabbage-leaf
>compresses to lesion tonight.My best guess is that this is not HSV
>because lesion initially milky not serous and infant is healthy. I
>suspect this is Pump damage. What are your thoughts? What would you have
>done with this phone call? When I call her tomorrow, do you have any
>words of wisdom?

If mother missplaced the flange over the breast/nipple wrong or if she has
full/engorged breasts with taunt, tight skin,  sometimes a bruise or abrasion
may occur if suction is placed on high.  That is why it is so important to
use the pump appropriately-- to comfort.  I would have suggested USP modified
lanolin to the flange to make easier movement on breast in flange.  To many
questions I have before I would suggest that though.  E-mail me if you have
any further questions.

"For is it not true that human progress is but a mighty growing pattern woven
together by the tenuous single threads united in a common effort?"  Madame
Chiang Kai-sheh

Pat Bull, RN, IBCLC
The Breastfeeding Connection/Medela
Naperville, IL -wish it would warm up here