I am scheduled to see a mom today who has been a challenge from the
first.  She is not a gung-ho breastfeeder, but was open to all my
suggestions for keeping a good milk supply (no bottles, etc.) when she
heard the reasoning.

About 1 week prior to delivery her MD gave her antibiotics for a
plugged duct (?) and when I saw her in the hospital she had a firm area,
dime sized, at about 8 to 10 oclock on the L nipple base still in the
areola.  It had been unchanged from the antibiotics.  We tried warm
packs, pumping, etc without change as well.  Sonogram the following day
suggested it might be a cyst.  At first there were no problems.  Infant
was game to latch on her very large nipples even with the firm area.
Latch looked good and there were plenty of swallows and the nipple shape
was pretty good coming out of his mouth even though the spot on the side
 really doesn't mold. We tried different holds of course to see if we
could work around that cyst. None seemed to feel any better than the
other. Then she began to get sore and since she was sore both sides and
had had the antibiotics, we suggested Gentian Violet and Newman's
Ointment. She has started her second round of Gentian Violet and is
coming to see me today.  She's not sure of any benefit to having the
cyst drained if she is equally sore on both sides.

Any lights of inspiration out there?

Kathleen Sacks, RN, IBCLC

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