What should the Red Sox do with Mike Napoli?

David Ortiz's first home start at first base since 2005 represented the confluence of several variables, among them the value of having the defense of Alejandro De Aza and Shane Victorino in the outfield corners, the merit of having De Aza's bat in the lineup against a righthanded starter, and the benefit of having Ramirez's bat but not his glove in the lineup.

Yet in many ways, those all represented secondary factors behind a more glaring one: Mike Napoli still isn't hitting. His struggles have become so severe that the Sox felt both Napoli and the team benefited from a first-in-a-decade use of Ortiz.

Napoli is hitting .192 with a .294 OBP and .358 slugging mark. Among 116 qualifying regulars, only Napoli and Stephen Drew have an average below .200 and an OBP below .300.

Those numbers are unnecessary to recognize the weight of what Napoli is going through. The 33-year-old can't conceal the albatross that accompanies him.

"I'm on what's supposed to be a winning team and I'm not producing. It's taking a toll on me," said Napoli. "If you're not mentally frustrated, there's something wrong. But I come here every day to work and try to fix it. … I wake up every day thinking that today's the day. I'm just going to keep working, keep doing what I've done in my career, to get out of this thing."

For now, manager John Farrell said the Red Sox viewed Sunday's lineup as a one-time alignment. Ortiz isn't about to become an everyday first baseman, but for one day (preceding an off-day), the Sox wanted to permit Napoli extra time to work with hitting coach Chili Davis in hopes of locking in his swing.

"[Sunday] was a day to get him a little bit of a breather with tomorrow being the offday and a couple days to regroup," Farrell said. "The hard contact has been inconsistent. I think there have been times where he's looked for a certain pitch in a count and not gotten it, and it's resulted in a located pitch by a pitcher. He fully recognizes where he's at and continues to work and getting this thing turned around."

Napoli's work and commitment has never been a question. Yet the Red Sox soon face some hard decisions regarding their first baseman's fate.

Dustin Pedroia's return from the disabled list is nigh, which will return Brock Holt to the status of a nomadic lineup staple. De Aza has been one of the team's best players since the Sox acquired him from the Orioles; until his magic carpet ride stops, the team will keep him in the lineup against righthanded pitchers. Victorino is back, too, exacerbating the bottleneck.

There's a great deal of trust and faith in Napoli from different corners of the Red Sox organization, where his impact as a key contributor to a championship team hasn't been forgotten. There's a reason why members of the coaching staff have long pointed to him and Pedroia when trying to tell young players the right way to approach the game.

But some evaluators wonder whether it is that very trait – the responsibility and weight Napoli feels he shoulders with the Sox – that might be making it more difficult for him to escape his brutal first half. If that's the case, then a change of scenery might be in his best interests.

Moreover, there comes a time when track record and a sound process become secondary to the desperation for production. And as Sunday suggests, there's little question that a point nears where Napoli's place in the lineup will cease to be a foregone conclusion. And it's also safe to say that the Red Sox are at the point where they have to contemplate alternative possibilities.

For that reason, it raised eyebrows that Pablo Sandoval took groundballs at first base earlier in the weekend. One team source said that Sandoval took grounders there simply because the dirt on the left side of the infield had just been watered, rendering it unavailable for infield work.

That said, it's not hard to imagine the Sox exploring playing Sandoval and Holt on the corners, particularly against righties. There's an argument to be made that Sandoval would be better suited for first than Holt.

Sandoval, whose defense as measured by Baseball Information Solutions has graded as 13 runs below average at third this year, has 63 games of big league experience at first base and has graded at two runs above average there. Holt, in limited playing time at the corners, has graded as average at third and first this year. Or, the team could use Holt as its primary first baseman.

If the Sox pursue such a strategy, they could either keep Napoli and give him playing time against lefties or send him elsewhere in a trade where Boston assumed most of his remaining salary of a bit under $8 million. As much as Napoli has struggled, it's not hard to imagine contenders in need of production at first base who would be willing to place a small wager on a second-half hot streak.

Napoli owns a career .245/.346/.456 line in the first half, and marks of .265/.367/.524 after the All-Star break, with his .892 post-break OPS ranking 18th in the majors – one spot ahead of Buster Posey, one spot behind Robinson Cano – since 2006.

Among teams who could stand to upgrade their first base production are the Astros (Chris Carter is hitting .195/.311/.401 and grades as seven runs below average according to BIS), Mariners (primary first baseman Logan Morrison, a lefthanded hitter, owns a .236/.309/.384 line), perhaps the Nationals depending on how the team views Ryan Zimmerman after a first half spent struggling with poor performance and then injury, or a Rays team that has a .227/.283/.342 line from its first basemen (with the obvious caveat that the Sox and Rays would be unlikely to consummate a trade unless the Sox fall completely out of the race).

Of course, there's still a last chance for Napoli to get hot with the Sox and to reassert his status as the team's first baseman going forward. That is the first baseman's intention.

"I'm going to hit. It's just me being able to bring what I do in my work before the game, in the cage and batting practice into the game," said Napoli. "I'm confident. I went out there [Sunday] and had a really good session."

But with the All-Star break and the July 31 trade deadline coming ever closer, the window for a turnaround is narrowing, even as Napoli works to keep it pried open.

Follow Alex Speier on Twitter at @alexspeier.