Painful Breastfeeding

Hi K.,
Thrush can be really hard to get rid of. Try looking at the info. on www.drjacknewman.com He has the best info on thrush. There is a specific way that you take Diflucan. You usually have to take more then one dose of it. You can find that information in the book "Medication and Mother's Milk" by Dr. Thomas Hale. Some Dr. offices have the book. If you need more help feel free to send me a private message. Hang in there.
K.

I had the SAME problem.

The shooting pains were the worst and are vasospasms in the breast. They are made worse when there is a yeast infection.

You and the baby have to be treated with the same meds. I live in NYC and here there is a DR of breastfeeding medicine that I saw that was able to prescribe for both of us. At first we tried the nystatin and it didnt work so then we switched to diflucan and and triple mixture cream to apply to my nipples after every feeding

We also got acidopholus (sp?) capsules, opened them and mixed with water to form a paste and put in on my nipples and the babies tongue once a day.

It is often a problem to get the OB and pediatrician on the same page.
Check out this website, Jack newman has some good thoughts on treatment
http://www.kellymom.com/bf/concerns/thrush/thrush-resourc...

I hope you get it resolved soon, i remember how painful it was, Stay away from the lanolin creams!! it makes the yeast worse

Good luck!

The best medicine to help your nipples heal is your milk itself. After each feeding and off and on throughout the day, express a little milk and rub it completely around the dark portion of the nipples. (The actual name for this part of the anatomy escapes me at the moment; I had a horrible migraine that landed me in the ER this past weekend so I was out of it most of the week after an injection of Dilaudid and Phenergan). This should help with the soreness as well as the healing. Do this especially after each feeling.

Make certain when your baby is latching on, that he is doing so correctly. Be certain he is taking the entire brown portion of the nipple into his mouth. If he isn't, then press your pinky finger between his mouth and your nipple to sort of "pop" the seal. If you take him off otherwise, it will cause soreness, pain, and even bleeding, plus the baby will be none too pleased at being taken off the breast once he gets going.

Are you sure you're not engorged? If your milk production is too high and your breasts too full, it will be difficult for the baby to latch on. If this happens, run a tub of warm to hot water but not too hot in order to allow your milk to let down. Once the water warms, have someone bring you the baby or have him in the bassinet so you can take him into the tub with you so you can nurse him there. I called Le Leche League (they are online by the way, and you can call and/or email them. If you need answers quickly, please call them! They are the best resource I found when I needed help in the early days and throughout the tough times when I was nursing and I did so for about 10 months until my daughter basically weaned herself to a cup.)

The La Leche League's International Web Address is http://www.llli.org/. Just find the country, state, area that is local to you and you should be able to locate a toll free number. Even if it's not a toll-free call these days, their help and answers are well worth the cost of the call. I learned so much from the phone calls and received much-needed support. Breast-feeding was not a big thing around here where I live until, or so it seemed, I began breast-feeding my daughter even when we were out in public. Of course I covered up well and often, especially when she was newborn to about 6mos, she was in a baby-sling that an elderly woman made for me. It doubled when she was older as a sort of side pack then a back-pack almost like a papoose sack that either my great-great-grandmother (Arapaho Indian) or the other great-great-grandmother (Cherokee) would have used when carrying their children around. My maternal great-grandfather was full Cherokee and took an Arapaho bride. Being that my birth father's family are primarily Cherokee with the exception of 2 brothers who came over from Ireland back in the 1600s then married Cherokee wives, my family is mostly Native American. It came in handy when having both my children. I had access to items the elderly women made that they used when their children were small that most mothers don't have access too b/c the commercial retail industry simply doesn't know of these products or can't make enough money off them or probably most of all, they would rather make something so cheap it would put the child in danger rather than something that can pass from one generation to the next or last through multiple children.... that's just my opinion. Others' opinions may vary...

Give La Leche League a call. A breast-feeding counselor can give you a great deal of information that may help your doctor figure out what is wrong.

BTW, when you are home, I presume you are a SAHM right now, go without your bra as often as possible. The likely culprit of the yeast is having your breasts bound up in an ill-fitting, non-breast-feeding style bra that is not made from cotton so it cannot breath and therefore it is breeding bacteria instead. When I had to wear bras, I had the lady from Sears fit me with cotton nursing bras that had clasps that were easily undone and done back again through shirts that were also fitted for nursing through. I also had cotton pads I wore to protect against leakage when my supply was heavy and I had to go out. When home, I generally went bra-less as often as possible. I wore a fancied strapless bra cut down with extra cotton padding that I could wash in the sanitary cycle in a laundering bag for undies, bras, and lingerie. I washed everything in that baby brand of detergent... the name escapes me but it makes everything softer too. It also has a great cleaning agent in it. I have a set of HE washer/dryer with the risers in a front-loader set. It's an HE3T Kenmore. It has a sanitary cycle and the machine includes an independent heater that heats the water to the correct degree to ensure anything run through that specific cycle comes out sanitary. I washed the one pacifier my daughters would take through the dishwasher under a similar sanitary cycle as our dishwasher also has that extra built-in heater to heat the water to a higher temperature than the hot water heater does.

Again, air to your breasts and rubbing a few drops of your bodies milk on the nipples does a great job in healing. Try your hand at making the make-shift strapless bra. It's not as if you will wear it outside your home. I couldn't see to sew a stitch and had given away my electric sewing machine by that time so I had a time making a straight stitch but the end result turned out quite well. I sewed in a couple of the rewashable pad inserts for your bras when nursing or after the birth of a baby to help absorb any extra milk flow. It worked wonders to help because the braline was always below the nipple line allowing me to wear extra-large airy shirts to let the air in and stop the binding and growth of bacteria. It helped me lots; perhaps it can help you too.

One more thing, I used the pump one time then learned I could express milk by hand much faster and with less pain than with a pump. Once I did this, I NEVER used the pump again. I recall the pump making my breasts hurt like mad. It felt like both were bruised beyond belief like someone had pulled all the blood to the surface like a big bruise or something. Expressing by hand never did this. There is an area that I always refer to as the "sweet spot" where if you start there, then sort of press and pull the milk will flow like a faucet. Maybe it was the years I spent living on a farm where I milked not only cows but goats as well. Believe or not but I actually brought home a bobcat who was pregnant and my mother and birth father nearly went into fits! They let me keep her at home until she delivered but she ended up delivering more kits than she could nurse. She had 15 kits in total. She could only nurse 8. We took turns alternating out nursing the kits so each could receive milk from their mom while the others received a milk mixture our vet helped us come up with for the kits so they could grow. Eventually, I was able to teach the mother to teach the kits to hunt and with the help of a wildlife worker who was rather upset with me but ultimately realized I knew what I was doing and in the end I did a good thing, we were able to reintroduce the family back into the wild. I also ended up with a raccoon too... Everyone whose ever known me, especially my birth mother and my surrogate mother (her oldest sister who was more like a mother for me) always said any stray within a 100 mile radius would find its way to my house, especially if it were hurt, hungry, or pregnant. LOL! I've took them all in. The raccoon was actually brought to me by a cousin after the baby's mother was accidentally killed in a trash compacter at a company near where she worked. She didn't know what to do and didn't want to turn the animal over to the wildlife group so she brought the baby raccoon to me and I raised it. Sam lived a long, healthy, happy, and fun-filled life. Even today I still have strays. My cat is from an animal shelter although he's on up in age now. I lost a manic Quaker parrot who was upwards of 50 years old about 2 years ago. It took me about 6 months before she would let me handle her without wanting to rip me to shreds. I wore gloves to start with then I was able to handle her with bare hands. Eventually she even allowed my youngest daughter to handle her and her major fear was of small children b/c the home she was saved from had 6 children all under the age of 11 who tortured her constantly. She was loud, nearly bald, looked horrible, her beak was in terrible shape, and her toenails were even worse. Plus, she was on a seed diet vs appropriate pellets, fresh veggies, oatmeal (with cinnamon - they LOVE cinnamon!), and plenty of fresh water with other treats offered plus playtime EVERY day several times a day. She was fortunate to have lived as long as she did considering the shape she was in when she came to me. She shrieked all day and all night long. Once she began accustom to someone talking to her, she quieted down and began to actually talk in words then in sentences. Nobody ever thought she'd learn to talk as old as she was but she did. I miss her terribly. This has been my life in addition to taking care of horses, dogs (I have had two guide dogs and my second is currently in partial retirement due to old age), cats, parrots, various types of birds including pigeons and finches, ferrets, cows, pigs (pet pot-bellies and the farm variety), etc... I've helped deliver babies too including a set of twin goats, which I had never heard of but looked up as an adult and learned it wasn't as uncommon as I first believed it to be. I've helped with a c-section on a foal (horse) as well as a few natural births including turning one with the help of the vet in order to get the baby in P. to be born safely without losing both the mare and the foal. I've taken care of kittens abandoned by their mothers who refused to allow them to nurse & even taught one first-time mother cat and a first-time mother dog how to lay still to let their litters nurse. other times I've fed them myself with special-made bottles. I've hand-fed a few baby cockatoos too when helping out a friend who owned a pet store. But I digress...

It's a good thing I've always been an excellent researcher and had no qualms with calling companies or other sources for answers. That's sort of how I approached La Leche League. I had something important my daughter needed yet we were having problems that the local pediatrician, lactation counselor, and ob/gyn could not handle so I took it up a few pegs and gave them a try. They found the answers I needed to make it not only a wonderful experience but a successful one. My first child was unable to be breast-fed because of a discharge I was having that somehow make my breast-milk unhealthy for her; this child was sick throughout her entire childhood no matter how well I fed her as far as diet, clothed her, bundled her, etc... nothing worked. She stayed sick; however, with my youngest child who was breast-fed, she was only sick once a year, if that, from the time she was born right up until she was several years old. Once she began school of course she caught the occasional cold but still, she never had illnesses like her older sister, which I am forever thankful. At least one of them spent a childhood without always being sick.

Best of luck... and please forgive my rambling. I'm still on migraine meds which are making me a bit loopy at the moment. It's an attempt to prevent the former migraine from rebounding again. So far - so good. Wish me luck too.

Warmest regards and all my blessings...

Paise

I would recommend you have a feeding evaluation with a lactation consultant. With my second child, he had a high palate (roof of his mouth) & wouldn't extend his tongue over his gumline, therefore he couldn't transfer milk and when I tried to put him at the breast it hurt. I know yeast on your nipples is very painful and hard to get rid of. I had to use gentian violet (a purple colored antiungal). As far as increasing your milk supply, add more pumpings in (pump every 2 hours during the day (or everytime after you give him a bottle) & once at night), drink lots of water & relax. You are giving your baby the most precious gift, your breastmilk, even if it is from a bottle. Does it hurt when you pump? Good luck.

Hi - I'm so sorry to hear you're having such difficulty! This is probably a long shot, but have you noticed any small white spots on your nipples? I struggled with recurring plugged ducts when I was nursing (hard painful lump on one side of the breast; relieved with hot compresses, epsom salt soaks, and lots of nursing/pumping to get the plug out), and along with that, I used to get these small white spots that my LC said were "blebs" or milk blisters. Whenever I had one, I would have shooting pains in the affected breast for 2-3 hours after nursing (and since DD was nursing every 2-3 hours, I pretty much had them all the time). See here for more information (kellymom is a great breastfeeding advice website in general, BTW): http://www.kellymom.com/bf/concerns/mom/nipplebleb.html . Anyway, my LC said I was getting the blebs and plugged ducts because I was using too much lanolin - kind of like when you use a moisturizer that's too thick, and your face breaks out. So I stopped the lanolin and also started taking soy lecithin supplements, and thankfully never got another one. From reading your update and the other posts, it sounds like thrush and/or the frenulum is more likely to be your problem, but since what you said about having "shooting pains" reminded me so much of what I went through, I thought I'd put my 2 cents in too. Good luck!

P.S. Oh, and it might be worth taking the baby to a different pediatrician to get a second opinion about the frenulum, if yours is being obstructive?

Hi K.-

I can totally relate to your situation. BF'ing was extremely painful for me too. My baby wasn't latching on properly- she was getting milk but was sandwiching my nipple between her tongue and the roof of her mouth. Each time she would suck, I had shooting pains in my nipples. They eventually got cracked and bled. I consulted many LC's and none seemed to have a good long term remedy. I ended up using nipple shields (make sure to get the right size for you) and that allowed me to BF with much less pain (still hurt a bit). They aren't perfect though, they slip and slide around sometimes. But I used them w/lansinoh rubbed on the inside. I breastfed this way as much as I could (few times /day) then pumped & bottle fed rest of the time. I got Gerber breast cold/hot breastcompress too. Provides some temporary relief. You can also call LaLeche for help. Each person I spoke with had more advice to try. I know it's hard but at the end of the day, your baby is still getting breastmilk and that's what is important. Wish you luck- I know it's hard!!!

Is it mastitus? have you used the ointment on your nipples to ease the pain? It is something that begins with an "L" and has a purple tube. The lactation nurse will know. I used that b/c it hurt so bad the first two weeks. It sounds like mastitus, try calling the hospt nurses instead of just your doc's office. I am sure you still have the number from when you gave birth, sometimes they know a lot more b/c that is what they specialize in. I wonder if the baby is sucking soooo hard b/c it is not getting as much milk as it needs to stay full. Sometimes they latch on wrong too, my daughter latched on wrong for a little period of time and it hurt really bad. Pinch your nipple smaller and have your husband help guide your baby's mouth to it. If latching is good, then there has got to be an infection. Sorry I can't be of more help.

I was also thinking your baby may have a tongue tie. If your pediatrician will not support you, you may want to find a different doctor. I'm sorry you're in such a tough position.

You may think this is crazy but I would have a chiropractor check the base of your neck. you could have oversensitivity from a vertebra being out. I have had patients over the years with very sensitive breast that told me they got better after I worked on their neck. ( i am a physical therapist)How much are you bending down when you feed your son. Just an Idea good luck.

This could be a tough one. My answer could also sound a little crazy. I would like to know if you are holding your baby nice and high up to your breast? Sometimes, we have a tendency to allow the baby's bottom to be on our laps. Then, we hunch over to meet the baby's mouth. This would cause a pulling on the breast and subsequently the nipple. I like to say, "belly up to the bar" for the baby to be in good alignment for nursing. If this is the case, make sure you use a pillow on your lap to help hold baby up higher to your breast. Hope this helps. KAR

I followed Dr. Newmans protocol when I had thrush in addition to two rounds of Diflucan and I finally beat it http://www.drjacknewman.com/. You need to be boiling all pump parts that come in contact with the milk, pacifiers, toys etc. every day for 5 minutes. Also, you can not freeze the milk you are pumping. Otherwise if you give it to him down the road you risk reinfecting him with thrush. Do you have the right size shields on your breast pump? They make different sizes and if it's pulling your nipple wrong that could be adding to your misery.

Hang in there! It takes time but you can beat it.

I would try putting clotrimazole cream on your nipples after each feeding (I think the brand name is Lotramin?). It is absorbed by your skin within 15 minutes of applying it, so it will be safe for baby by the next time you feed. It is the only thing that worked for us, in addition to all you are doing. Oh, and we did the acidophilus as well. Both baby and I took Difulcan for one week. It is proven today that 50% of strains of yeast are resistant to Nystatin. I think doctors still go to it because they are comfortable with it. But, there is an oral suspension of Diflucan that is approved for babies older than 6 weeks.

It took us months to get rid of this. I hope you can get it cleared up sooner. You have to be persistent with the dr's. I had a few tell me maybe I should quit breastfeeding!

i'm thinking it's more an issue with his latch, at least initially... has anyone checked him for a tight frenulum? it's also referred to as being "tongue-tied"... they can't get quite as deep a latch and then your nipples get abused in the process of breastfeeding. an experienced lactation nurse should be able to spot it, though, so if your lactation nurse looked at him and thought it was ok, that might not be it. although-- might be worth getting a pediatric dentist to take a look at him. i'm an ob nurse and besides seeing it at work, i've had a friend who had two babies, both with tight frenulums. they can be stretched out (i think), but more commonly, if it's presenting a problem, they clip them-- it's a quick procedure that i've seen them do in the hospital while moms are on the mother baby unit. no anesthesia, no big ordeal. although if they decide his needs to be clipped, since he's a bit older, it may be more involved. might be worth checking out. good luck to you, whatever you decide to do!

yes, have the baby checked by someone in your area for the tongue tie. Usually it is an ENT. The important point to discuss with them is that the baby's suck is non-functional. Most doctor's do not consider a tight frenulum a medical problem b/c you can always give them a bottle in their opinion. But for a parent wanting to BF it is nonfunctional and needs to be released. Hopefully your LC has a contact for your second opinion.
Also, a pediatric certified chiropractor can work along side this procedure to help release any jaw tensions that decrease the baby's gape or opening of the mandible that would increase latch pressure and decrease the distance the jaw ans tongue could come down and out during the latch process; check out www.icpa4kids.org to find someone near you if interested.
Best of luck.

My SIL had that, and after 11 painful months of breastfeeding (crying with every nursing session) she rejoiced when her daughter weaned. While I give her full credit for breastfeeding through the pain, she discovered too late that it was all due to a painful latch! She b/f her other two children without pain.

Get the book "Breastfeeding with Comfort and Joy" [http://www.breastfeedingwithcomfortandjoy.com] and discover more about a proper latch than even most LCs know. In my SIL's case, the LC in her hospital told her the latch was fine, but it obviously wasn't.

You could try soaking your nipples in white vinegar. I dont know if it would help but worth a shot.

If yeast is an issue, taking a prescription may be helpful in the short term only. It's not just an infection that can be treated as easily as MD's would like to lead you to believe. You should consider following a Candida (yeast overgrowth) Diet recommendations. See this site for lots of info: http://www.candida-cure-recipes.com/candida-diet-guidelin.... Over 85% of Americans have an over abundance of yeast due to the amount of soda, pasta, and breads consumed. So, following this will healthy regimen is good for the whole family. I followed a similar regimen, due to the amount of yeast in my body and I quickly started losing 2 - 5 lbs a week. It was amazing. If you do this, your milk will be healthy for your baby as well. Plus, it lay a great foundation for when sold foods come into play. Then introducing Whole foods won't be as big a transition.

Oh, and putting some small cold packs or cold damp clothes on your nipples (maybe even cold water in the shower) should help with some of the discomfort. Cold therapy is always good if there is pain and/or swelling.

Good luck to you and your baby!

If it is thrush, look for MotherLove Diaper Cream and Thrush. I used it as a nipple cream (it is safe for baby, and is mainly olive oil based). Does your baby also have it on his bottom? If so, you can get another jar for that. I had really bad nipples while breastfeeding, that bled and eventually became damaged (a lot more severe than the bleeding), and no one seemed able to help me, even after 14.5 months of breastfeeding. They finally healed after weaning. Oh, and I found a really great breastpad too if you need one.

Are you getting engorged at all? You may try to pump before feeding. I think that ultimately, this was my problem, but by the time I realized it, the damage was done. You seem to have caught this before any damage, but unfortunately, still have the pain.. If you are too engorged, then the baby can't latch right and it can cause pain.

Sorry, that is all I have to offer, but I have been there. At least it sounds like those around you are trying to help, and if there is any more information I can give, let me know.

Have you tried Lansinoh/lanolin ointment? I developed really painful breasts a few months into breastfeeding - had sharp shooting pain, especially after feeding - for almost an hour. It was also really painful during nursing. After a couple weeks of just dealing with the pain, I decided to try the lanolin - it worked!! I guess my nipples were cracked, but I couldn't really see anything, so I hadn't thought that that was the problem. After a few weeks of using it, it feels alot better. It's worth a try.