My client gave permission to describe her problem for your feedback. A 33yo
who breastfed her 3 1/2 yo daughter X15mo without problems, and is now
discouraged, asking if it is possible to wean on only one side in phone
conversation today, for the following reasons. Strongly desires to continue
breastfeeding her son who is healthy in the 95th percentile with the
exception of being treated for thrush, however is exhausted by recurrent
problems. Mom working closely with MD, has had clogged ducts with cords at
12:00 on R br only, 2x wkly past 2-3 months, has been on Diflucan x 14d mid
Aug, mid July did various creams for both vag & breast and Nystatin for
babe. MD requested U/S which revealed normal breast. Pt called for
lactation consult abt 3 weeks ago. I observed deep latch, w clothing
rolled over breast at 12:00, reviewed teaching for clogged ducts & counter
pressure, gave Newmans breast compression handout, teaching concept,
reviewed and affirmed recommendations being followed for yeast.
Client reports by phone today (Sat) that the clogged ducts had resolved, she
was using the breast compressions, for the past 2 1/2 weeks, she was
beginning to believe the only problem to resolve was the yeast. Then 24
hours ago, with what seemed to be over night, waking in the morning to find
the cords reappeared, (babe cosleeps and nurses frequently at night) She
reports that when the cords are present she feels crummy, extra tired,
denies fever, malaise, or being hit by a Mac Truck and has not been treated
for mastitis. She used the sterile needle to help unclog the duct and
reported taking over 12 hours w frequent nursing on that side, using
compressions to resolve the cords at 12:00. Today in reviewing any possible
changes, we determined she has started treatment for possible dermatitis on
that areola. We explored the possibility of the creams clogging that duct.
She denied noting any change in the sucking on that breast compared to the L
side, but will try and observe more closely for this. She is experiencing
some stress with her hubby firefighting in the wilderness, out of state the
past 2 weeks.
I have not been able to keep up with the list serve for a month or so...
missing all the great discussions. Thank you for your collective expertise
and suggestions in helping problem solve and encourage this mom.
Pamela Arnott RN, BSN, IBCLC
<<Pamela Arnott.vcf>>
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