Hello Wise Women,
Mother has given permission to post:
I have been working with a woman with a now 8 wk. old who had quite, sore damaged nipples initially with obvious nipple wounds.
Mom has very good supply, which baby manages.  We've been working on latch and nipple wounds have healed but some "pinching", sometimes also described as "sandpaper" sharp with feeds pain perisists when baby latched.  Though not all the time.  Also, ache in breasts between feeds, which I thought are vasospasms b/c of original damage.
B.W. 3222 g.  Wt. today 4798 g.
She takes regular tylenol and uses heat between feeds to make it manageable.
After the nipple wounds were healed, but some pink remained and pain with latch, which we continue to work on, I suggested multipurpose nipple cream, which she discussed with and got from her family doctor.
This made things worse!
Well it turned out that he had ordered cortisone 1%, bactroban and miconazole not mixed, but in 3 seperate tubes.
This allowed us to experiment with what was the problem.  She felt worse with the cortisol, so we stopped.  Then we tried the antifungal and intitially it improved the pain, but then it got worse.  Same pattern with the bactroban.
I went to her house today and was a bit at a loss, but then saw the mother lick her hand "to wipe off the medication" prior to latching.  
I have advised her not to do this, especially while treating her sore nipples.  The plan is to use stop using mom's saliva at the breast and try the bactroban for 48 hrs. to see if the situation improves.  
Has anyone had this situation?
Could this be contributing to the continued pain?
Any other ideas?
Thanks,
Tina
LLLL, RN, IBCLC
Port Alberni, BC
Canada
  		 	   		  

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