I had almost the exact same situation with my first child. Months of sore
pink nipples. Several rounds of diflucan and gentian violet. I ended up at
the dermatologist who told me to stop using all soap, lotion, and perfume
with scents and colors. Started using a very very mild soap for bath even
though I had never "washed" my nipples. Told me to stop using fabric
softener on all my clothes, and start using a "free and clear" detergent for
clothes. Basically told me that I had what was like a chemical burn on my
nipples. He prescribed Locoid Lipocream for my nipples after every feeding.
It took about a week or two, but I was cured. To this day I can't use
regular clothing detergent on my clothes while nursing a baby or fabric
softener and I have to use a very mild soap to bathe with. I nurse pain-free
but I do have sensitive skin on my nipples especially while nursing. I hope
this helps I know how frustrating this can be day in and day out. Stacee
Baker, RN
----- Original Message -----
From: "LuAnn Smith" <[log in to unmask]>
To: <[log in to unmask]>
Sent: Thursday, May 24, 2007 6:53 PM
Subject: Unsolved Case of Sore Nipples
> Dear Wise Ones,
>
> I've been working with a primip mom of a 7 week old and have her
> permission to post. She has been sore since birth. Infant was born by C/D
> for breech. The baby has a bubble palate and mom has works to get a gaping
> wide latch. Today I worked to obtain a deeper and more asymmetrical latch
> and mom noted a slight improvement, nothing remarkable. Her nipples are
> erect, pliable, normal size and shape and breasts are WNL as well.
>
> Baby diagnosed with reflux , currently treated with Prilosec after Zantac
> was found ineffective. On inspection mother's nipples are red and inflamed
> not shiny, but with some blistering at times and some white spot on
> occasion. Mom has been treated for a over a month for yeast. Baby has
> never had any visible symptoms, just "gas". She denies a history of yeast
> infections, and neither her or the baby has been on antibiotics.
>
> She has been on a full course of nipple ointment minus clotrimazole, then
> treated with a clotrimazole gel preparation offered by her midwife, and
> then took a full course of diflucan over a 14 day period. Her nipples are
> no better and has been totally unresponsive to treatment to date. Mom's
> gut tells her this is not yeast. OB was going to consider gentian violet
> but moms nipple are so raw, that I hesitate, because I'm also not sure it
> is yeast at all.
>
> Mom gives a hx of sensitive skin, with outbreaks of dermatitis. She noted
> some on her arms after the birth of this baby, but no real issues at this
> time and she is fair skinned with freckles, She also admits to having
> blanching of her hands in cold weather, but has never sought medical
> treatment for this.
> For the next 2-3 days she is going to take a break from all creams and
> lotions and is considering a dermatology consult. I have her trying maalox
> on her nipples in case the baby's acid reflux has caused a caustic skin
> reaction ( I really am grasping at straws!)
>
> What do you think the next step should be. Her OB wants me to "fix her"
> and we are all a bit perplexed. Gentian violet, nifedipine?
>
> She notes a raw, burning sensation after nursing and a cut glass feeling
> with latching. To my knowledge she has not done much pumping, only feeding
> at the breast.
>
> Any and all suggestions will be greatly appreciated.
>
> LuAnn Smith
> York, PA
>
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