I have permission to post. Experienced and long-term breastfeeder, now with
3rd child, 7 wks old. I forgot to ask if C-section or vaginal birth. Large
breasts and nipples and latch problems from day 1. Mother began expressing
immediately, hand expressing until mik cam in then pumping. No tongue tie
noted. Mother experienced nipple pain from 1st days in the hospital. Has
tried nipple shields as baby always had trouble latching, but shields are
just not large enough for her nipples. Has combined bf and pumping (with
the largest flanges).

Over the last 7 wks has had confirmed thrush (by doctor) in baby's mouth
x2. Had mastitis on or around week 2 to 3 with fever, left breast. Been
treated with Bactrim (Sulfamethoxazole/Trimethoprim) x 2 courses, Keflex
(cephalexin) 500 mg four times daily x 10 days (concurrent with one of the
bactrim courses, recently), nystatin to nipples, then later antibiotic
ointment to nipples, Fluconazole 2 doses (1 day apart) x 2 courses. Also
has tried gentian violet x1. She first was treated for thrush/yeast and
later for bacterial infection. No cultures.

Continues to have pain in left armpit and down left side of breast. Nothing
has improved this pain over many weeks. No palpable lump. States she has no
history of eczema or other skin disorders.

Baby has an upper lip tie and Mother is pursuing Ear/nose/throat doctor or
pediatric dentist to evaluate.

I have suggested culture of nipples and clean catch midstream specimen of
milk cultured. Also I have suggested ultrasound of breast. I have also
suggested possible dermatology consult. Where or who should I steer this
mother to?

Also she is in north Mississippi, and wonders if any of you can suggest a
good doctor who might treat her and one who will evaluate/treat her baby
for lip tie and possible posterior tongue tie. She is ready to expand her
search for breastfeeding-friendly and experienced doctors.

Laurie Wheeler RN MN IBCLC
MISSISSIPPI USA

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