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Subject:
From:
"Landry, Evelyn D." <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 22 Oct 2008 13:20:42 -0500
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I just got a call from a mother and wondered if anyone might  have some
insight as to where to direct this mother  if I am not thinking through this
well:

Very experienced mother - long time breastfeeding 1-2 years with each child
or longer
4th baby about 10 months
Started in Sept. with crack at base of Left nipple only.

Dr. treated for yeast with APNO and after little improvement went to
Diflucan
When she called me the baby was not being treated - contacted her Pedi and
baby was put on Nystatin and both continued to be treated

Little improvement after the Diflucan with one treatment - Dr who has also
nursed her children still thinks it is yeast.
Mom now on Diflucan for 5th week -  Baby now on Diflucan.
Mother describes the nipple only areas as "burning fire" pain during and
immediately after nursing

Now  both the left and right nipples both  broken skin - Dr. tried Bactroban
only (mother reported this burned her nipples a lot - did not see much
change.
Dr. put mother on another ointment called Biafine but not much change noted.

This mother called me today and is absolutely at the "end" she is literally
crying if she nurses her baby and is even awakened at night with the pain in
both nipples only.

Mother describes the nipple areas as cracks in the skin ( like tears at the
base of each nipple).  Skin seems to be peeling off.  
Mother has cut out sweets and lowered her carbs

Pumping is a little less painful, but this baby has never had a bottle or
pacifier since birth and refuses a bottle.  I suggested using a sippy cup
with breastmilk - 

Mother is planning to see a dermatologist today and will ask that a culture
be done.   I keep wondering if this is a Staph infection???  MRSA???

Any suggestions would be appreciated.
Evelyn Landry, RN, IBCLC, RLC
(337) 289-7227 Wk
(337) 288-5719  Cell




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