What is this itchy red patch on my breast?
January 16, 2010 3:35 PM   Subscribe

YANAD, but what is this itchy red patch on my breast? I'm breastfeeding.

It's on the areola, and has been here about a month. Only on the left breast. The size of the area does not change; it's red and dry and slightly flakey. I've been treating it with lanolin, which helps the itching and dryness, but it still isn't healing.

I don't think it's thrush (other breast unaffected, baby's mouth looks normal); the baby is 8 months old and we've had no prior problems other than a few plugged ducts (on the other breast). I do have very dry skin and it's winter right now, so pretty dry generally.

I doubt it's related, but I've been having tinnitus for about a month as well. (I need to see a doctor for that, but there were the holidays and then a bout of winter bleck, so it hasn't happened yet.)

Any ideas? My GP isn't a nursing or breast-care specialist and it's hard to get in to my ob/gyn. My google-fu has failed me.
posted by anonymous to Health & Fitness (16 answers total)
 
Perhaps you have developed eczema?

IANAD, but I've had three babies. :)
posted by Edubya at 3:45 PM on January 16, 2010


Some people are sensitive to lanolin. You might try avoiding it to see if that helps.
posted by kch at 3:51 PM on January 16, 2010


It might be a fungal infection. Perhaps you could upload a photo. As an emergency doctor who deals with uncertainty all the time, I would consider a diagnostic / therapeutic trial of putting some OTC antifungal (clotrimazole, for instance) on the spot for a few days to see if it gets better.
posted by mert at 3:52 PM on January 16, 2010


This may be completely obvious - but if you do follow mert's advice, don't nurse on that side - pump and discard the milk until you're done using the antifungal cream. Although it does seem unlikely to me (not doctor) that you'd have a fungal infection for that long without affecting the baby.

I recommend calling your ob and asking a nurse about it over the phone. They may be able tell you if it's something that needs to be looked at or if there's something stronger than lanolin that's safe to use. If that's not possible, you could also try calling the hospital where you gave birth (if they have lactation consultants on staff) or asking your pediatrician (mine has helped me with nursing problems in the past).
posted by Dojie at 4:37 PM on January 16, 2010


This might be a dumb question, but do you always nurse with the baby positioned the same way? I had something similar, and it cleared up when I changed to a different nursing position (football hold instead of across my lap, or laying down, etc). I think it was contact irritation from having a sweaty little chin pressed against the same spot all the time. I also have dry skin. So you might try repositioning for a few days and see if that helps.

I question the advice that you use an anti-fungal cream, you need to pump and dump. My understanding is that if you use any topical treatments (other than something like the Lansinoh lanolin ointment), you should just be sure to wash it off before nursing, and then re-apply when you're done. A topical treatment shouldn't contaminate your milk.
posted by Lulu's Pink Converse at 4:50 PM on January 16, 2010


Red, dry, flaky and itchy does sound like eczema. If it is eczema, then Eucerin lotion and/or Aquaphor ointment can help. Wash the area before feeding baby, though, then reapply after the feed.
posted by fancyoats at 4:52 PM on January 16, 2010


I keep getting itchy red patches on the skin under my bra, particularly along the top binding edge (breastfeeding 8.5 month old)... they clear up in two days or so when I go without a bra for as many hours as I can. In my case, it seems to be connected to getting hot and sweaty while wearing a bra... maybe I'm reacting to spandex/lycra or whatever it is that makes the bra stretchy.

I know of a doctor in CT that specializes in breastfeeding specifically. If you want, memail me and I'll get you her info; maybe you could get a phone consult.
posted by xo at 5:19 PM on January 16, 2010


That sounds just like the eczema I got on my nipple (that has to be one of THE most irritating spots to have eczema!). It improved when I used Lansinoh, but didn't heal until I got a steroid cream from the dermatologist.

If you can't get in to see your OB, maybe go see a dermatologist. It is a skin thing, after all.
posted by christinetheslp at 5:46 PM on January 16, 2010


Lulu's Pink Converse is right vis-a-vis Dojie's odd advice.

"In general, topical products... that are applied to the skin do not end up in breastmilk, due to poor absorption into mom's bloodstream."

Nth excema and that a dermatologist is the best person to consult.
posted by kmennie at 6:07 PM on January 16, 2010


You might contact La Leche League, they are the nursing experts, and will help you without encouraging you to stop nourishing your child like a doctor might.

It could be a 'callous' type thing from the way the baby suckles, or an irritation. I agree about not using any lotion, perhaps some coconut oil or olive oil instead?
posted by Jinx of the 2nd Law at 7:30 PM on January 16, 2010


Mrs. mbd1mbd1 here (breastfeeding 6 month old) with two links about APNO (all purpose nipple ointment). It does require a prescription and a pharmacy that will do compounding - I went to CVS after calling to check that they had all the ingredients. Note that the instructions specifically say not to wash the ointment off. My lactation consultant also recommended a dermatologist if my problems didn't resolve with careful use of the ointment (they did).
posted by mbd1mbd1 at 7:47 PM on January 16, 2010 [1 favorite]


Try some Cortaid. That is probably your best bet.
posted by verapamil at 8:54 PM on January 16, 2010


I recently got a some Aquaphor at Wallgreens. The stuff works great as a healing ointment.
It was recommended by my tattoo artist for healing fresh tats. It's thick like lanolin, but is petrolatum based.
posted by Balisong at 9:06 PM on January 16, 2010


Could be chapping from putting a wet nipple back in your bra. Maybe try the following routine after each feed: rinse nipple, let dry completely (maybe use a hair dryer), apply Aquafor. Then wash nipple with mild soap before the next feed. You could also try using disposable nursing pads, and change them after each feed. Basically trying to keep wetness away from the irritated area.
posted by palliser at 9:10 PM on January 16, 2010


My lactation consultant swears by the APNO that Mrs mbd1mbd1 recommends. I recently had a break out of rashes all over (including my breast) and had to go to a dermatologist, got some steroid cream, and it's finally getting better. Mine isn't on the nipple but I didn't have to wash it off before breastfeeding.

So try changing positions and call your OB to have them prescribe the APNO (and call the pharmacist to make sure they can make it before you go there). If that doesn't work, have your GP find you a dermatologist that will take you short notice (which can be very very difficult).
posted by katers890 at 6:36 PM on January 17, 2010


Oh, and they sell these hydrogel pads (that's just one example) that you can use instead of the lanolin which I think worked better and are reusable and you can take them off when you need to feed. Might help.
posted by katers890 at 6:40 PM on January 17, 2010


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