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Lactation Information and Discussion <[log in to unmask]>
Date:
Sat, 15 Jan 2005 20:33:25 -0600
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What you are describing "ulcers on the tip of the tongue" sounds more like
Herpes Simplex Virus I (not to be confused with HSVII which causes genital
herpes) this is the "cold sore" but in children the first time they get it, it
is extremely painful and causes high fever, and multiple ulcers in the mouth
(can be in the back but generally on the tongue and gums thus the name
"gingivostomatitis").  Hand Foot and Mouth is caused by Coxsackie virus, they
are blisters rather than ulcers and generally are on the back of the throat,
the palms and the feet, they appear there rather than being transferred, the
same virus causes cold symptom and diarrhea in older people, usually not a very
high fever and not as painfull as HSVI, the virus is contagious but the
"blisters" per se are not. (Although they can be in the front of the mouth,
they are generally in the back its confusing because this is called
"herpangina"!) HSVI on the other hand is spread by direct contact! Children
often develop the sores on their chin from drooling and on the thumb from
sucking- that is called a "herpetic whitlow" It can look very nasty- it sounds
like the mom might have this on her nipple- I don't know what to recommend, I
discussed this once theoretically with Dr Dermer who felt that maybe
breastfeeding is contraindicated, but it is so counterintuitive since the
biggest problem with HSVI is the risk of dehydration from not drinking due to
the pain. Maybe a nipple shield? Also Acyclovir can be used however it is most
effective when began early in the course.  They can both just "get through"
this with pain control, ice, ibuprofen, and a mixture of maalox and banadryl
1:1 painted on the lesions. I would put bactroban on moms lesion so it doesn't
get superinfected, and I always recommend probiotics (ie acidophillus,
lactobacillus) to help "fight" the infection.

Amy Kotler MD FAAP
Dover Pediatrics

Quoting "DiaperFabric.com" <[log in to unmask]>:

> Can this be transfered from a nursing baby to the mothers nipples? 18 month
> old baby has what looks like ulcers inside the mouth, on the tip of the
> tongue. Mom has scabby ulcer looking sores on her nipples. This has been
> going on for 3 days. Baby does not have any signs of this on her hands or
> feet, but has had high fever and is very fussy. Shes not eating other than
> nursing. Mom thought it was thrush, but now suspects hfmd.
>
> (.Y.)   Mona K Harris
>

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