Thank you Cindy!

On Wed, May 8, 2019 at 1:32 PM Cindy Garrison <[log in to unmask]> wrote:

> Dear Tamara,
>
> This has been going on for a long time without resolution.  It seems
> appropriate to consider other possibilities, such as treating for
> vasospasm/Reynaud's.  Consulting a dermatologist seems appropriate, as does
> culturing mom's milk to rule out staph.  I've been taking the GOLD
> Lactation conference online and one session addressed persistent pain
> during breastfeeding.  Alexandra Glass MD, a breast surgeon and IBCLC, was
> concerned about over use of fluconazole as it is hard on the liver. She
> likes using an APNO-type ointment.  She gave ideas for treating for
> vasospasm that included Vitamin B6 @150mg, Calcium @2000mg with Magnesium
> @1000 mg (watch for diarrhea in mom), using nifedipine if true Raynaud's
> @30mg extended release per day.  She also mentioned using warmth and
> compression of the nipple to move blood into nipple by either compressing
> at base of nipple with warm fingers or at edge of areola and moving toward
> nipple.  If truly thrush, EVERYONE washes hands before and after touching
> baby; mom needs reminded to boil everything that enters baby's mouth; if
> she and husband are intimate, he also needs checked for yeast; and check
> the pets for yeast as well.  Other ideas I have found helpful is for mom to
> watch diet - low carb, low sugar.
>
> Cindy Garrison BS IBCLC
>
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