I am facing a frustrating consult this morning.  Mom called
describing shooting pains in her breasts (she was actually referred
to us by her OB who felt we would know more about this than she
does-yea!).  In the course of the conversation, she also reported
"bright pink and shiny" nipples/areolae.  Baby has developed a
blotchy diaper rash and has a "whitish tongue BEFORE feeding".
Since she was already taking baby to the Ped. that morning I
suggested she ask about thrush Rx since what she was describing was
"consistent with thrush". (Have to put it that way to avoid being
accused of diagnosing!)  Apparantly the Ped looked in baby's mouth
and did not see "cotton balls" coating the tongue, so told her there
was "no thrush".  Mom called back to report this and asdded that she
now has developed a rash under her breasts.  She is coming in for me
to "cure" her breast pain.  I will certainly look for other factors,
but really feel my hands are tied.  I would love to say, "This Ped
is an idiot who doesn't want a "non-doc" to even suggest what a
problem might be, so what do you expect me to do?"  However, I will
try to be as diplomatic as possible while trying to save the
breastfeeding relationship.  I will try to balance my frustration
with the joy I felt yesterday when I talked to our current "crop" of
student nurses and one said how much I helped her when she had her
baby 6 years ago!

Winnie

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