Debbie,

The first thing I think of in reading this is that the latch/position needs
improved.  The tear at the base of the nipple suggests that the baby may
be putting
excess tension on that side and is perhaps directing the force of the
suck onto the
opposite tissue.  Perhaps, over time, this is creating a sort of
hematoma in the
nipple.

You might suggest to the mother that she evaluate how the baby faces the breast.
Is the baby "square" on the breast, i.e. are the nose and chin against
the skin and
are the cheeks equal distances from the breast?  Is she able to direct
the nipple
toward the palate, thus guiding it over the tongue more completely, in a more
asymmetric latch?

It would really help if you could see her positioning and the baby's latch.
Observation by anyone seems to be missing in the history she shared.

Cindy Garrison, BS, IBCLC
Canonsburg, PA


> Subject: purple bump
> Date: Fri, 7 Jan 2005 11:53:42 EST
> From: [log in to unmask]
>
> Kathleen's post about thrush and Raynauds made me think of a mom I spoke
> with briefly during BF moms group: mom of a few week old baby has a persistent
> (at least two weeks) firm purple bump on a nipple,  bump about the size of
> montgomery tubercle, but on the nipple face, ~7 o'clock position, .....she says
> that nipple becomes progressively painful,  to the point of not  tolerable,
> and bleeds slightly w/BF, ......gets progressively less painful, but  bump does
> not resolve, w/pumping, no observable blood w/pumping, ....a  couple of weeks
> ago she and baby were treated for yeast and she states that it  cleared and
> this is not the same pain,............but she also describes a  recurring small
> fissure at base of that nipple on the opposite side from the  purple bump,
> this fissure recurs when she trys to go back to BF instead of  pumping on that
> side, ......she says that the other nipple is "OK" but that  it does get a
> little purple, not white, with frequent BF.
>
> what ya think?............ persistent yeast with Raynauds(?),  .......plugged
> duct/nipple bleb that has some old blood in it resulting  in purple color (?)
>
> Debbie  Tobin
> RN BSN IBCLC LCCE
> _LCAGW.org_ (http://www.lcagw.org/)
> Co-VP
> Springfield, Virginia USA
> In the  Fairfax County suburbs outside the Washington DC beltway
>
> _BestBreastfeeding.Info_ (http://www.bestbreastfeeding.info/)
>
>

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