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Breast Feeding

Painful skin on areola part 2

10/25/1999

Question:

First off, thanks for the thorough response. I really appreciate it.

At my second appointment a week ago she did a yeast culture which came back negative. The first doctor 9 days ago said that he couldn`t do a bacterial culture because there is always bacteria on the skin and those only work in surgical type situations.

That first doctor did say that it didn`t look bacterial. He did say to come back in a week if I was still having problems.

Well, things are a little better, but not much. Out of despiration I tried a silver and water treatment from a friend. It actually seemed to do as well as anything. I thought things were clearing up but now they are back to getting worse again. My skin sticks to my 100% cotton bra and pulls off leaving little exposed and lightly bleeding patches.

I did get my referral to a dermatologist but the soonest appointment was Oct 25th. I guess now I`m holding out until then.

I have also been trying polysporin.

I did make a pumping change which was the beginning of this 3 weeks of skin problems, I added the insert to the Medela pump that caused a crack that I put lanolin on (and I`m not sure it was the hypoallegenic kind).

This condition seems to be baffling many people. The lactation consultant had not seen anything like it. The doctor was OK saying it was just "normal" skin healing. The second doctor thought it was yeast which it wasn`t.

Hopefully the dermatologist can help.

I have not pumped for 2 weeks. Naomi now has her days and nights mixed up as far as food is concerned. I feed her every 3 hours at night and then she goes from 7am-1:30pm without a bottle, takes 4 oz of formula and then I feed her again at 5pm.

The only added thing is that now there has been more itching. At first I thought this may be healing but things stopped getting better and began going the other way.

3 weeks is a long time to wait for a simple crack at the base of the nipple to heal. At the beginning the cracks I got on the top of the nipple healed in 3 days.

Thanks again.

Answer:

It is really baffling when breastfeeding is going well and then a small change in the routine seems to cause a problem. Unfortunately, there is not too much I can add to my previous response without being able to see the skin in question. I hope the dermatologist is able to identify what is causing the uncomfortable skin changes on your nipple and areola. The cracks are likely to heal fairly quickly once the cause of the problem is identified and the proper remedy is recommended for the affected areas.

Rereading the information in your first post, the symptoms still seem consistent with a yeast and/or a bacterial infection. If you used an unpurified lanolin on your nipples when the pump inserts caused some irritation, and you are allergic to wool, it is possible that an allergic reaction to lanolin further irritated that skin. However, this irritated skin still may have gotten infected with bacteria since then. If you tried an antibacterial ointment on the cracked areas, it is possible that the ointment got rid of some of the good bacteria which keep candida/yeast from growing, so candida/yeast infection still is a possibility too. If the dermatologist suspects a bacterial and/or candida/yeast infection, ask how you should treat Naomi or you may find you and she keep giving it back and forth to one another.

I again recommend contacting the pump company that made the inserts which seem to be associated with the initial irritation so you can find out if others have reported similar symptoms with insert use.

Good luck and hang in there. Fortunately, breastfeeding problems often resolve as quickly as they arise once appropriate treatment has begun.

For more information:

Go to the Breast Feeding health topic, where you can:

Response by:

Karen Kerkhoff Gromada, MSN, RN, IBCLC
Adjunct Clinical Instructor
College of Nursing
University of Cincinnati