This baby is having a very difficult time breastfeeding. She is four months old and this issue started approximately 3 weeks ago. Mother reports she had a cold prior to this issue starting. Baby is not congested and has been seen by her provider to rule out ear infection, etc. She is crying, clicking, and repeatedly pulling off the breast anytime that she is awake for a feeding. She does ok when she is sleep feeding. She gags at the breast, bottle, and pacifier. She occasionally has nasal regurgitation. I did a suck exam and found this-- inclusion cyst? It is large, white and firm. I saw baby at ~1 week old and did not note this in the documentation for the suck exam. Baby is defensive during gentle suck exam and as soon as you reach this spot she pulls back and begins to push forward with her tongue. I'm hoping somebody can provide me with insight as far as what this is? It is much larger than any Epstein pearl I have seen before. Could this be sensitive and causing baby discomfort during feeding? What can be done to help her if this is the case? Is there a referral outside of her family practice provider that should be considered?

Thanks for your help :)


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