Brenda,
Is there any possibility that the nipple has a bacterial infection, such as staph? Sometimes persistent sore nipples that don't clear up, and that are associated with breast pain of the type you describe (deep, radiating burning pain, unrelated to feeding times), may have bacterial involvement. See the Canadian article by Livingstone & Stringer in the Sept 1999 JHL, in which appropriate systemic antibiotics worked better than the other treatment modalities. [REF. Livingston V, Stringer J. The treatment of staphyloccus aureus infected sore nipples: a randomized comparative study.JHL 1999;15(3):241-246.] Treating for candida isn't gong to clear up staph - if that is what it is. It makes sense to check it out.
I had a Mum with an older baby several years ago, with impetigo on the nipple/areola. The baby was mobile and had picked up the infection, on her face, and transferred it to her Mum. The Mum originally rang me thinking it was thrush, but on asking for more details it was clear to me that she needed to go straight to a dr for a bacterial infection, rather than come to me. The dr agreed with me, identified staph aureus, and appropriate treatment was made. By this time the mother had a small crater at the site, but this didn't interfere with breastfeeding. [REF: Thorley V. Impetigo on the aareola and nipple. Breastfeeding Review 2000; 8(2):25-26.]
Don't take my word for it - go read the Livingston & Stringer article. I learnt a lot from it.
Virginia
in sunny Brisbane
Brenda Phipps wrote:
have a mom with a 10-month old... sudden onset of nipple pain
about 3 weeks ago, on just one side. Nipple looks normal, but mother
descirbes the pain as "burning" during the feeding. Baby has no s/s of
thrush, and no history of antibiotics. > The pain is excruciating .... is now painful even after the feeding is over. No signs of blebs. Could this be thrush? I don't think I have ever known a mom with thrush on just one side. Anybody seen this?
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