Kathy, thanks for your reply.

Mom # 3 had been pumping with small flange for about 7-8 days. She 
switched to larger flange about 8 days ago at which time I noticed 
yellowish crusting on the tips of her nipples and started her on Bactroban 
ointment. The pain did not get any better. 

Clindamycin was started 3 days ago and as of yesterday she did not have 
much relief. The pain is worst during pumping and the nipples are 
exquisitely sensitive to touch. The lumps in her breast don't change much 
after pumping. 

This is a very stoic mom. She didn't complain about pain until I probed 
her. I did ask her to take Ibuprofen 600 mg TID.

I'm keeping my fingers crossed.

Vaishali Kute, MD FAAP
Atlanta GA

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