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Subject:
From:
"Glass, Marsha" <[log in to unmask]>
Reply To:
Lactation Information and Discussion <[log in to unmask]>
Date:
Wed, 10 Oct 2001 14:45:07 -0500
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I have just this week had a case like Winnie's and the original poster, whom
I responded to privately, thinking it a late response that someone would
have answered by the time I got caught up on my LN reading!  The mother I
worked with has symptoms classic for yeast with history of abx use since
delivery 2 weeks ago and vaginal yeast infections during pregnancy.  Baby
also has red bottom she is treating for diaper rash.  Mother talked to peds,
who was reluctant to prescribe tx for thrush at first but, after mom had an
especially bad night, went ahead and gave her Nystatin.  Her ob had also
been reluctant to prescribe tx after ped had initially declined.  She came
in and I helped her with baby's latch, which was quite shallow initially.
However, baby is gaining very well and mother has only a very small spot
that appears traumatized on one nipple.  Pain was initially in one breast,
now going to second one.  No trauma to second nipple.  If baby's latch were
that bad, I wouldn't expect to see such a good weight gain or so little
(almost none, really) trauma of the nipples.  She thought it was much better
after we fixed the latch, so the plan was that she was going to wait a few
days and see what happened.  If the latch was the problem, she should be
much better from here out, but I told her if it was yeast, this wouldn't
help the other symptoms.  Her breast pain was much worse at night, BTW,
which is classic for yeast, and did not end with feedings.  She said she'd
be up for a few hours during the night in pain and the only relief was to
lean over and let her breasts 'dangle'.  I gave her a copy of Kay Hoover's
excellent reprint on yeast and pointed out the quote, "

"Since there is little to see on the nipples and the baby and/or mother may
be aymptomatic, it is appropriate to treat the mother and baby based on the
woman's description of her pain."

I would have opted for treatment anyway, going with the adage, Can't hurt,
might help ("and it's a helluva crowd pleaser", that a direct quote from an
ER nurse!), but mom preferred to wait and see.  I plan to call her in a few
days and see what has transpired.

Marsha

~~~~~~~~~~~~~~~~~~~~~~~~~~~
Marsha Glass RN, BSN, IBCLC
Mothers have as powerful an influence over the welfare of future generations
as all other earthly causes combined.
John S. C. Abbot
~~~~~~~~~~~~~~~~~~~~~~~~~~~

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