Got a breastfeeding/ lactation question?

Write to: LC Doris Fok c/o Q&A Lactation, MotherNeeds, 141 Lentor Street, Singapore 786838, or fax us at 6456-0031, or email info@motherneeds.com with "Ask LC Doris" as your subject heading.
Please limit your queries/questions to a maximum of 150 words.

Doris will select 2 letters to be answered every month. Selected letters published here win a S$12 gift certificate for purchases at our MotherNeeds online store.

Visit our Archives for breastfeeding topics previously addressed.

Copyright © 2004

Question 1:
Dear Doris,

I have a stubborn itch on my breast, accompanied by a small white spot on my breast. I suspect it is a fungal growth due to the moisture and trapped heat while wearing my breastpads. Occasionally, I experience sharp shooting pains in the nipple (like it's pricked by a needle).

I have been applying a topical fungal cream, Triderm, for 1 week and it has worked well to relieve the itch. However, it has not dissipated the white spot on the skin. I also find it cumbersome and not very effective because I would have to wash it off completely prior to feeding my baby. When washed off, I feel it is counterproductive because the fungal cream is no longer there to do its job. I have vaguely heard about gentian violet, particularly about how it is "safer" for babies that come into contact with it. Would I be suitable for this treatment?

Thank you.
Eleanor Sim

Answer 1:
Dear Eleanor,

Thank you for your question. Triderm is a medication prescribed by a doctor for broad spectrum infections. It covers fungal infections as well. However it needs to be removed before you breastfeed your baby, so please use the PP wash which you can buy from any pharmacy. Ask about how to dilute the solution before use.

If your white spot doesn't resolve within this period, please seek the help of a qualified lactation consultant to determine what to do with it.

Regards,
Doris Fok

Question 2:
Dear Doris,

I have been breastfeeding my baby fully since his birth, with occasional feeds of water by my family. He is now 5 months old, weighing 4.5kg (weight taken as at 4 months 3 weeks). My baby weighed 3.04kg at birth, and experienced a drop in weight at 10 days old (to 2+kg), before re-gaining to his current birth weight. I am concerned if my baby is getting enough breastmilk.

I am currently nursing him every hour. He is sometimes fussy at the breast, straightening his back while crying and refusing to nurse. He is not given the bottle regularly (aside from a few incidences when he was 2 months old). I've been informed by 2 paediatricians whom we recently visited (for a fever he was having), that my baby is underweight and that I may have low breastmilk supply, because of his frequent (hourly) feeding. I am even more concerned when they warned me that my baby may not develop enough muscle to sit up, if he continues to be underweight.

My breasts are no longer engorged, and my other breast does not leak when I nurse. I often do not feel any let down as well. Do breastfed babies follow a different growth chart of their own? Should I be concerned about my breastmilk supply or could his fussing and frequent feeding simply be a growth spurt he is experiencing? Please help.

Thank you.
Ummimusa

Answer 2:
Dear Ummimusa,

I am really concerned about your baby's growth. Please see a lactation consultant as soon as possible to assess your breastfeeding and who can work with your baby's paediatrician and you to help you. Do not delay anymore as we need to understand why your baby has not gained sufficient weight.

Regards,
Doris Fok

*We regret that only 2 letters will be answered by Doris every month.

Neither the information nor any opinion expressed constitutes a medical consultation or prescription or treatment of a medical or health condition. This column is prepared for general viewing and is published for general information only. It does not have regard to the specific medical or health condition, and the particular needs of any specific person who may receive this information. Persons needing medical attention should seek advice from his/her healthcare practitioner regarding the appropriateness of information discussed or recommended in this column. Should you have a pressing question or issue concerning your medical or health condition, please consult your healthcare practitioner.

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