Lyla,
My first thought is that, whether or not there is pinching, a chiro/CST referral is appropriate.  I also agree with Rachel--all of these symptoms are in the progression common with posterior TT. Ask her if there is a feeling like sandpaper on her nipples? I hate that she is using all of these drugs. This is, IMO, a structural problem.



Jennifer Tow, IBCLC, CT, USA
Intuitive Parenting Network LLC


-----Original Message-----





no medical history pertinent to breastfeeding problems.

baby born at a watebirth center, my partner saw her within a few hours =
of the delivery, because it hurt to breastfeed almost immediately.=20

oral anatomy normal, no indications for cranial sacral, normal birth, =
normal breasts and nipples, and NO COMPRESSION of the nipple upon =
nursing.  and yet pain.  terrible horrible pain.

i saw her a few days later, and her nipples were pink, and she had some =
yeasty symptoms, so she started candida protocols. =20

no improvement. =20

a week or so later she started nifedipene (she had already been taking =
omega 3s, vitamins, using APNO, etc. etc.

the nifedipine seemed to help a little bit, but she still was writing me =
several times a week saying she was in terrible pain.  the in between =
pain seemed to fade but hte nursing pain was still ominpresent.  the =
only visable symptom is/was bright pink nipples.=20

she made an appointment with a derm with whom we've had good success =
treating hard pain cases.  here is what he prescribed/recommended, in =
her words:

=A9      On Mon. March 18th, saw Dr. Gasch (Dermatology).  He diagnosed =
dermatitis of the nipple and mastitis; in association with dry skin =
(which was allowing bacteria to enter the nipple through cracks in the =
skin).  He recommended discontinuing the Nifedipine and beginning a new =
treatment plan:  600mg of Advil every 6-8 hours (to reduce =
inflammation), washing with CeraVe Hydrating Cleanser, applying Alcortin =
to the nipple in the AM & PM, and applying Plastabase to the nipple =
before and after nursing.  I began this treatment plan that afternoon.

=A9      For the next week, I continued to take my final week of =
Nifedipine (since it appeared to be helping - I was hesitant to not =
finish the dosage) along with following the new regime to treat the =
dermatitis/mastitis.

=A9      On Wed. March 26th, I took my final dose of my 1-month =
Nifedipine - while continuing the skin-care regime.  During the next =
week, my nipples began to feel "itchy/scratchy" during feeds and =
relatively painless between feeds (though still extremely sensitive).

=A9      On Wed. April 2nd, _____ began to "click/smack" on the breast =
(frequently breaking the suction).  I tried to change her position, but =
she continued this behavior at every feed (and throughout the feed).  =
This continued for about 3 additional days.

=A9      By Thurs. April 3rd, my left breast began to become =
increasingly sore, with an increasing burning sensation and extreme =
sensitivity.  The pain/sensitivity continued to increase (in the right =
breast as well) over the next 4 days.  During this time, I noticed that =
the nipples were both continuing to blanch after feedings (bright white =
to a dark maroon color).  =20

=A9      On Tues. April 8th, I saw Dr. Gasch - as the pain in my left =
breast was becoming nearly intolerable.  He reconfirmed a diagnosis of =
nipple dermatitis and a possible yeast infection.  He prescribed =
continuing the application of Alcortin to the nipple in the AM & PM, =
applying Plastabase to the nipple after every feeding, and washing with =
CeraVe cleanser.  He also added to the treatment a 150mg tablet of =
Fluconazole taken daily for 10 days along with 600mg of Advil daily.  If =
I didn't see improvement in 2 weeks, I cold replace the Advil with =
Prednisone: two 20 mg tablets taken for three days, then one 20 mg =
tablet taken for three days, followed by one 10 mg tablet taken for =
three days.  He commented that the "itchy/scratchy' feeling I had =
experienced the prior week likely a histamine response, but did not =
suggest an antihistamine at this time.  He suggested a follow-up visit =
in one month, but I scheduled for two weeks out.  After the intensity of =
the pain increased over the afternoon, I decided to start taking the =
Prednisone immediately in lieu of continuing the Advil.  For the =
remainder of the day and through the night I always started to feed =
___on the right breast - as the left beast was too painful to nurse.






 




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