Winnie writes: Apparantly the Ped looked in baby's mouth
and did not see "cotton balls" coating the tongue, so told her there
was "no thrush". Mom called back to report this and asdded that she
now has developed a rash under her breasts. She is coming in for me
to "cure" her breast pain. I will certainly look for other factors,
but really feel my hands are tied. I would love to say, "This Ped
is an idiot who doesn't want a "non-doc" to even suggest what a
problem might be, so what do you expect me to do?" However, I will
try to be as diplomatic as possible while trying to save the
breastfeeding relationship. I will try to balance my frustration
with the joy I felt yesterday when I talked to our current "crop" of
student nurses and one said how much I helped her when she had her
baby 6 years ago!
Winnie, I would do a consult with the mother and if, as it pretty clearly
sounds, (shiny nipples, shooting pains, rash under the breast) this mom's sx are
indeed consistent with yeast, then I would call her OB to get tx for her and
would also call the pedi to share your findings. If you are able to tell the
pediatrician that the OB has diagnosed yeast in mom, he/she may be more willing
to treat the baby, especially if you explain that mother and baby are apt to
pass the yeast infection back in forth. Of course you'll have to be ever so
polite and play a little dumb--maybe act like you don't know pedi has ever
actually seen baby for this particular problem. Too bad we have to play these games,
isn't it?
Kathy Boggs, RN, IBCLC
Mountain View, CA
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