In relation to the message about the mother of the 10 month old with nipple 
pain.....

This is a shot in the dark, but does this mom have any history of eczema, 
even a small history or minute signs of it on her body now?

I recently went through a very taxing experience with a patient and friend of 
mine.  She had 2 children whom she tried to BF with bad results. It was 
always painful for her and she ultimately ended up pumping and bottle feeding 
each one.  When she got pregnant with her 3rd, I was determined to help her 
make this work so that she could enjoy the full experience of breastfeeding!  
Unfortunately , the night she delivered we had a horrible snow storm and I 
could not get to the hospital bc I had my own newborn nursling at home.  
Long story short, she got off to another rocky start.  When I saw her the next 
day, her nipples were irritated, but she could still nurse, we suspected it might 
be a latch issue and worked on that.  Soon after she started into the 
downward spiral that had so familiarly plagued her in the past.  She ended up 
seeing a physician at her 6 week appointment who told her to quit bc "six 
weeks is long enough to breastfeed". She was cracked and irritated and 
emailed pictures of her breasts to me, they had an obvious yeast infection 
and I advised her to go back and have someone take another look.  Sure 
enough it was yeast and she was treated.  Even after treatment, she never 
felt right, she still ended up pumping and bottle feeding. All the while, in the 
back of my mind I remembered her history of eczema.  From time to time I 
would urge her to see a dermatologist and not an OB (my contact with the my 
friend was limited due to my new baby, so most of the conversations were 
over the phone).  Sadly, she stopped nursing around 4 months, but I 
encouraged her that she pushed through a lot to at least give the baby a 
great start in life.  It has been several months now since she quit and she still 
had issues with the nipple, finally went to see the dematologist. Lo and 
behold, eczema.  

To make a short point from a very long story.  Her nipples were compromised 
already from the eczema, which made her prone to yeast and irritation.  I'm 
not sure if this will help your patient in any way, but maybe the story will let a 
lightbulb go of in someone's head!

Another thought...maybe it is the baby's teeth.  Could the baby have bitten 
her at one point?  Also, I've noticed with my own, there is a different latch 
when they are teething/have teeth....not to mention how active they become 
at the breast!

Well, good luck.  I have only recently begun to post on lacnet, and I am a 
new IBCLC.  I do not have the wealth of experience that I see when I read 
some of the postings, but I have been an  L&D nurse for 12 years and nursed 
my own 4 children, so I guess that counts for a little...and I am learning a lot , 
I think it is so great to be able to consult with eachother.

I hope you get to the bottom of this and she does not have to quit.

Vicki

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