A LLLL friend posted this to me.  Do any of you have ideas for this case?

Patricia Gima, IBCLC
Milwaukee

I have a question about deep breast pain in one breast.  The mother is
 nursing her 7 month old daughter.  The baby eats very minimal solids.
When baby was
 about 2 weeks old, I visited her at home because she was experiencing very
 sore nipples.  (This is her second baby)  The baby appeared to me to latch
 on correctly and suckled well.  She did, however, seem to pop off the breast
 frequently, and that seemed to be the only plausible cause for the very sore
 nipples (mom is brunette with brown eyes).  I gave her a Lansinoh sample I
 had.  I called her about 3 days later, and her husband said things were
 better.  I've seen her occasionally between then and today, and baby is
 obviously doing well.

 Now I've just seen her tonight at a community function and she is
 experiencing not only deep breast pain, but bloody milk in that breast.
She says it's
 not a cracked nipple that's bleeding, but that there's blood coming out
with the
 milk.

 She's been to her OB, who examined the breast and found no lumps.  Mom said
 it wasn't sore for him to examine the breast, but if she applies pressure to
 the nipple, it does hurt.  Having her bra touch the nipple area hurts.   He
 told her it was a muscle thing, and to just let the "muscle
 heal" - in other words, to just wean.  She told him that wasn't an option
 right now, as baby takes just about all her food from the breast - plus, mom
 doesn't want to wean .

 I asked if baby or mom had been sick recently.  Baby had a pretty bad cold,
 but is doing fine.  She's obviously thriving on breast milk.  Looks and acts
 very healthy and age appropriate to me.

 Mom says she's been pretty tired lately and has joined an exercise program
 to lose some weight.  She says she's not seeing much improvement.  I asked if
 it was possible she's pregnant (might account for the tiredness, but what
about
 the breast pain and blood . . .)

 Dr. gave her some Diflucan 150mg (fluconazole), sort of as a "shot in the
 dark", that this might be a yeast infection.  Neither baby nor mom has any
 symptoms of yeast, but that doesn't mean they're not infected, right?


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