Hello all,
 
    It has been a while since I have even lurked so I will  reintroduce 
myself before I pose my question. I am an LC, hospital based in  Charlottesville, 
VI will resit the exam this year. I have learned so much from  reading over the 
years. I thank you all for your words of wisdom.
    I have a mother who has given me permission to post her  situation as my 
colleage and I are stumped. Our client is a G3L3 with a 6  mo who has worked 
hard with this delivery to get her milk supply up. (She had  problems w/ the 
other 2 and I believe she has PCOS). Anyway, she has a recurring  spot on her 
nipple that I thought was a bleb but that has not resolved. Let me  give you her 
history. Within one week after delivery, she and baby were  being treated for 
thrush.She developed a red raised rash from the  Nystatin. Around April 7th, 
she noted clogged ducts high up on L breast  that resolved. Then she noted the 
white spot on her L  nipple. She was able  to "buff" it away but it would 
return. She never felt a clogged duct up the  breast from that point. Her PMD 
treated her w/ a topical antibiotic cream but it  did not change the spot. She 
would see it disappear but return after a couple of  days. It would be white 
right after nursing  and then become flesh colored.  It is pinpoint in size with 
a red semi circle around it and milk flows through  it. She describes the pain 
as a tender, pulsing achiness. She does admit that  side does make less milk 
than the Right.
     She would like to continue to breastfeed. We have  discussed 
breastfeeding only on the right since the baby has a good appetite and  is eating solids. 
We have also discussed the possibility of needing to see a  dermatologist.
     Any suggestions?
 
 
Thank you,
Allyson  Michaels RN, IBCLC




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