Am repeating this post as received so few (2) responses (for which I'm
grateful) and would very much like to hear from others to gain more and
varied info. Is it perhaps because this was a weekend post? Thanks! (Hope
I'm not out of line in doing this.)
Date: 1/20/01 4:35:15 PM Eastern Standard Time
Dear Wise Ones,
I'd appreciate input on the following case; for the sake of brevity will not
include all details and treatments but only those which pertain to this
particular situation:
mother: experiencing areolar pain where tongue and lower jaw touch,
sometimes on top, as well, where infant's upper lip touches(have flanged
upper lip after latch and this helps-no evidence of labial frenulum
irregularity) has areolar swelling affecting entire areola following
breastfeeds, sometimes begins to swell during feed, also plugged ducts
throughout breast-different spots (on Lecithin for almost 2 wks now) hx
thrush-tx 2 wks Diflucan, Lotrimin and Jack's nipple ointment, now on 2nd day
tx with gentian violet with some relief; has always had pain in L breast that
radiates from nipple at about 8 o'clock to mid sternum, this can occur during
feed, after feed and is sporadic; pain with original thrush was typical
shooting, burning internally and itchy breasts-this thrush pain disappeared
when on Diflucan
infant: age 8 weeks; has high palate, suck disorganization, oral thrush
evidenced by mom's symptoms and drooling (drooling not present before thrush
recurrence one week ago); does not appear to be clenching as jaw seems
relaxed, tongue over gum, but Mom stated today that she felt the lower areola
discomfort when baby sucking rapidly before a swallow and not during swallow
or when swallowing rhythmically; wt loss for past week but with increase
supply and 1 1/2 oz supp at breast of EBM gained 3.6 oz in 2 days; have
improved latch, used suck training briefly but mom said baby didn't like so
stopped and now is going back to trying since crisis passed of so much
nipple/breast pain, decreased supply and weight loss of baby, working on
deepening latch to bypass high palate; recommended therapist with NDT
(neuro-developmental training); baby has been treated with some change noted
by chiropractor of mom's
Question: Is areolar swelling all due to infant suck? If so, why would
entire areola swell and not just area of infant mouth? Could swelling be due
to thrush? (are these sinuses inflamed, perhaps?) Anatomy-ductal sinuses
close to skin surface(however don't feel that way but Mom isn't too keen on
breast palpation there as so tender)?
I feel that there are obvious multiple problems and trying to tx each one but
thought I could be missing something and how one problem impacts the other.
Any and all insights are appreciated!
Barbara Latterner, BSN, RN, IBCLC
Brewster, NY
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