Hi all,

I have been working with a mom who had early supply issues with which
she is still dealing.  However, with her permission I am writing about
another problem which she is experiencing and may cause her to give up
on breastfeeding.

At about 10 days post partum, she started with "shooting pain" starting
in the nipple and extending into the breast.  Antibiotics for sinus
infection just prior to labor and again during labor.  Vaginal yeast
infection during pregnancy.  No symptoms of thrush in baby.  OB office
did swab of nipple with drops of milk which was neg.  Mom said NP said
nipples looked irritated. She has had the discomfort now for about 10
days.  States it is varies from one breast to the other.  Notices most
discomfort when she awakens for middle of night feeding (about 4 AM).
The pain continues until mid-morning when it subsides some, but not
totally.  Also has complaints of occasional tender lumpiness which
resolves somewhat with heat and massage with feeding.

I am quite sure I read that culturing of nipple/ductal yeast is dfficult
and that a neg culture is not absolute.  Anyone know any references for
that?  If this isn't yeast, what else could it be?  Why no symptoms in
baby?

TIA,
Judy Hatfield RNC, IBCLC
Upstate NY

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