I did archives search, but need some further input about this case--mom would
love to resolve this problem.
5 mo. old baby--alert, active 18 lb. Totally breastfed--started adding some
strained fruits, vegs & cereal at 4 mos. Uncomplicated vag delivery of 10 lb.
baby. Initially had sore, cracked nipples but was resolved at 1 week after a
consult with LC & no problems since. Never had any mastitis, plugged duct. A
couple of weeks ago she suddenly started having pain in her right
nipple/areola. (She coincidently started baby on cereal 2 days before the
pain began.) Initially she gave cereal 1st then BF, but changed to BF 1st,
then cereal after getting advice from LC. Lt. breast & nipple are fine.
She describes the sensation as if "the nipple is a scab & the areola itches,
pain is sharp, stabbing." No hx of allergies, asthma, dermatitis, nor any
medical conditions. Her nipple & areola have no signs of trauma. The rt.
nipple may be slightly pinker than left. After nursing, the left nipple
looked OK, right nipple had 1 small round white area on tip which dissapeared
spontaneously, but no assymetry or creases. She did say that the night
feedings (side-lying) were a little more painful on the right side than
during the day. She normally holds baby closely with cradle hold to keep him
from squirming & pulling away. She & baby have no hx of yeast infections.
Baby's mouth is clear-no sign of thrush, no high palate, no teeth. Baby's
latch appears to be good, baby is distracted & pulls off nipple to look
around the room.
She has spoken to several breastfeeding specialists about the problem. Was
told that it was latch-on problem and another said yeast. She used lotrimin
cream on rt breast for 48 hrs with no improvement in symptoms. I did give her
the handout for Pat Gima's yeast treatment & advised her not to nurse in
side-lying position since she found it more painful. Also told her about
nursing in a quiet room without distractions. I also discussed the
information in Tom Hale's book re: diflucan.
So what do you all think? Is it yeast, positioning or some other strange
problem? She really wants to continue nursing this baby, but is very
discouraged by the continued pain.
Laura Hart
Winter Park, FL
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