I often see women whose nipple damage is hard to believe.  Kay Hoover and I
have a new photo of a mom I worked with in our new edition of the
Breastfeeding Atlas.  This woman had yellow, crystalized pus and bleeding
scabs all over her nipples from an untreated staph infection (cracks opened
by her tongue-tied infant's dysfunctional sucking.)  There's no way we could
have used the baby to drain the breasts and this woman was sick.  No way was
she going to be able to hand-express adequately.  It's been my experience
with her and literally hundreds of other mothers that if you have a good
(hospt. grade) pump set on low suction that  pumping doesn't hurt.  I
frequently rest the nipples 24 hrs or so while topical antibiotics help heal
superficial infection and oral antibiotics deal with systemic infection.  I
haven't had moms complain that pumping under these circumstances is painful.
I am very careful about the fit of the flange size, of course.  I don't want
a strangulation effect at the base of the nipple or abrasion on the shaft of
the nipple.

I obviously view re-positioning and latch as the first line of defense in
preventing and curing sore nipples, but I see a lot of mothers where we have
to drop back a step and get the nipples healed before she can tolerate any
further instruction.


Barbara Wilson-Clay BSEd, IBCLC
Austin Lactation Associates
http://www.lactnews.com

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