Her physician does not know what to do, but he is doing nothing about it. This behavior does NOT follow the standards by which medical care is practiced. Asking her to wean would be like me telling my adult male patients with erectile dysfunction- too bad, don't have sex, rather than referring them to a specialist. I should not prevent my patients from getting the highest level of care just because I don't know what to do.

It is unethical to not help her. Weaning increases the risk of illness during the pandemic, even the AAP recommends avoiding premature weaning during the pandemic.

I suggest going to bfmed.org, and search for a physician who practices breastfeeding medicine in that state. Now that we can do telehealth, physicians and other providers who practice breastfeeding medicine can care for patients all over their state, and most doctors are doing telemedicine now.

She likely has either mammary dysbiosis, dermatitis, or herpes of her nipples. This is not mysterious, rare, or difficult to diagnose, NOR IS IT ROCKET SCIENCE.  When infants have oral candidiasis, it can lead to a mammary dysbiosis in the breasts.

Feel free to share this with this person's physician.

Anne



Anne Eglash MD, IBCLC, FABM

Clinical Professor, Dept of Family and Community Medicine

University of Wisconsin School of Medicine and Public Health

Director, UW Breastfeeding Medicine

Medical Director, Mothers Milk Bank of the Western Great Lakes

Founder and President of The Institute for the Advancement of Breastfeeding and Lactation Education (IABLE)

www.lacted.org









Date:    Wed, 2 Dec 2020 13:36:17 +0000

From:    "Morgan, Julie E" <[log in to unmask]>

Subject: Diagnosis help



Permission to post:



I am currently nursing my fourth baby who is 7 months old. About 3 weeks ago I started having pain on my right side, my son had just popped his first tooth and i didn't think much of it. I then noticed a small wound under my nipple and started putting bacitracin on the area. Two days later I noticed redness and a clogged duct on this same breast with chills. So i immediately called into my Dr. for antibiotics for mastitis which i had with my first born and once already with this child. I started taking the antibiotics that day and normally within 24 hours with my others I was free of pain and everything was turning in the right direction. But with this one it seemed to just be getting worse and the wound under my nipple was becoming larger and the pain had moved to my left breast.  I waited 2 days hoping that it would get better with the antibiotics but it didn't. I then noticed white spots in my son's mouth which turned me straight to thrush. My son started and is continuing to take nystatin 3 times a day. and I went in immediately to receive a prescription for diflucan. I took one that day and then one 2 days later. It also did not seem to help the pain and I was dealing with a milk blister on my left side. I than was put on a 14 day round of diflucan and began Dr. Jack Newman's protocol a week and a half ago. Also adding in a warm rice bag after feedings in case i am dealing with raynaud's syndrome. My son's mouth has completely healed. His last day of nystatin is tomorrow but i am still in large amounts of pain all during nursing. I am now starting to have open wounds on the top of my nipples and things just do not feel right. For reference I have nursed 3 other children all to 14 months and my first son had a tongue and lip tie revision at 6 days old.



We have been through everything I can think of and the MD would like mom to switch to formula and will not do cultures.   Thanks so much for any ideas to help this mom.

Julie Morgan RN, IBCLC



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