Hello, okay, a brief intro. I am a CNM and IBCLC. I was on this list
several years ago, but had to quit when midwifery school took over my time.
Glad to be back.
Now, the substantive question:
A CNM friend has asked for my "expert" opinion. I couldn't come up with an
answer, and she gave permission for me to seek help from the collective you.
She has a client who is nursing her 4th baby. Breastfed all the others
also. Baby is 6 weeks old. Mom reported feeling deep "cut glass" pains in
her left breast during pregnancy (no detail when). At 6 weeks pp, mom is
now experiencing the same sensation, left breast only, and only for the
first minute to two of a feed. No nipple shiny-ness or redness. No nipple
pain. Baby's frenulum looks good. No observation by mom of plugged duct,
no redness or sore areas, afebrile, no indication of mastitis.
Mom thinks this is yeast. No thrush patches in baby's mouth. No diaper
rash. Mom has had diflucan 100 mg po BID x 3 days (yes, that is correct).
Mom has no vaginal sx of yeast, but is convinced it is yeast. Partner was
also treated same as mom. No relief from breast pain. Mom is boiling
everything, has used gentian violet, nystatin, everything from Riordan and
Auerbach, all with no relief.
I have suggested: 1. varying position...maybe by some stretch this will
help. 2. Mammo and or breast US...perhaps some anatomical issue? 3. culture
milk separately from each breast (I know...no real logic here, but just
looking for everything). 4. cytology slide of each nipple.
Help? Am I missing the obvious? I don't have all the info, as this is not
my patient, but I tried to pump my friend for everything she could tell me.
Thanks,
Lee-Ann
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