Has the doc ruled out psoriasis and impetigo?  A biopsy could be done,
although it's on a nipple that is being utilized frequently.  However, if
the misery is already bad enough, what's a little biopsy?

Have you considered a shield to prevent the baby's mouth and saliva from
coming in contact with the nipple.  Saliva contains an enzymatic mishmash
that may be causing her trouble.

There are so many skin problems out there that require a specialist that we
refer anything that doesn't respond to the "usual" treatment to a
dermatologist who has a specific interest in breastfeeding.  He has been
great!  With few exceptions the moms we have referred have been
discomfort-free within three days, and cured within two weeks.  I can't say
enough for having good dermatologic backup.
Deanne, R.N. IBCLC
NICU

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