Hi all,
It seems, based on the conclusions to this study, that we should be
suspecting and treating for bacterial infection in far greater numbers when
presented with sore, cracked nipples. I'm concerned about differentiating the
s/s as described from those of yeast ie; soreness, cracks, radiating,
sometimes prolonged pain... Maybe if we use presence of cracking as a
delineating factor but often these women have tiny, small cracks or abrasions
which makes this difficult.
I consulted with a mom yesterday; 3 wks. pp who is considering giving up BF
due to the pain; sore nipples AND breasts, radiating particularly after the
feed. On clinical eval.; nipples appear mostly intact- 1 small crack, sl.
inflamed but basically look good, small helpful changes in positioning
diminished latch on pain but didn't change radiating br. pain, no set up for
yeast. Milk supply is overabundant but not huge.. My first inclination was to
try a few days with above changes and ibuprofren, then think diflucan... but
am now wondering about systemic ABX- any ideas???
Lynn Shea Rn,Bsn,Ibclc
Franklin, Massachusetts

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