Linda, I have seen moms with apparent nipple thrush immediately postpartum.
Usually there's been a strong positive history of vaginal yeast in mom,
antibiotic use, thrush in other babies, etc.  The tip-off to look for it is as
you describe--great latch with no creasing or odd shape to the nipple when done,
but very painful nipples.  Mothers often have described the pain with nursing as
"scraping" or "like the baby has teeth."  If mom is pumping she usually has pain
with the suction set on minimum.  There have been a couple of moms who also had
tiny yellowish flecks on nipple and areola that cleared up with treatment--Kay
Hoover has a slide of one of these.  I've always assumed the mode of
transmission was partner's hand from infected vagina to breast during sex.

Which makes it unlikely that your mom has thrush!  If she can't stand for
anything to touch her breasts, it's unlikely there's been a lot of sex play
involved with them.  I also see mothers who seem to just have really sensitive
skin.  Some describe pain with no skin breakdown at all like this mother--I
think those do usually "toughen" within a week or two.  The modified lanolin
products are usually soothing.

I find it interesting that some mothers can get away with quite a bit of
imperfect positioning and creasing and no skin breakdown at all while others
with similar minor imperfections of latch will end up bleeding.  It seems as
though some women *do* have "tougher" skin than others.  I'm interested in what
other people see.

Becky Krumwiede, RN, IBCLC
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