Karen wished for more sore nipples, a problem that she feels that she can
handle.  I would like to give her a couple.  I have two persistent sore
nipple cases that are dragging on and on and I am stumped. (A third quit
before we went very far in exploration.)

We've fine-tuned suck and positioning. We've checked frenulums.(fenula?)
We've gone through thrush treatments several times, including the Big Gun,
Diflucan (both mom and baby) and nothing makes the nipples feel better.

One mother tried a cortizone cream and the nipples were worse after three
days.  She has made an appt with a dermatologist, but couldn't see him for
two weeks(!)  I know that there are different cort. bases and I hope she
will hold out until she can see the derm.

What about allergies?  Can a baby be rough on the nipples with an itchy
throat?  The nipple comes out round, not compressed. She has begun giving a
bottle of abm as "relief."  Could this compound the problem?

What else could this be?  I haven't before had a sore nipple case that we
couldn't resolve, or at least trace to the source.  I have had a cluster of
very stuborn cases lately.(Things do seem to come in "clumps.")

Could there be a psychological component to sore nipples?  Could this be her
body's assistance in weaning?

Is there anything you can think of that I haven't?  Would you like to come
to Milwaukee and lend a hand?

Patricia Gima, IBCLC
Milwaukee