vasospasms or systemic yeast??

[happydaymomma]

So, I have been on a very long and challenging bfing journey...

DD1 is 3 years old now. I nursed her until she was 2.5 when my milk dried up at 4 months pregnant with DD2. DD2 is now almost 4 weeks old and we are suffering majorly.

I experienced pain in my nipples the whole 2.5 years of nursing DD1, but thought (for some insane reason) that there was nothing I could do about it, so after about 10 months of pain I stopped keeping track and just gritted my teeth and bore it.

Now, with DD2, I'm trying really hard to figure out what it is because having a baby, and a toddler, and having a nightly meltdown (me) because of painful nursing is just not cool!

The pain I am feeling starts in my nipples and feels like someone is pushing a red hot poker down into my breast through my nipple. It could also be described as squirting jalapeno juice down into my nipple. It is a very sharp, hot pain. Then, sometimes I feel this same kind of pain in other parts of my breasts - sharp and hot. These I would describe as feeling like I'm being cut with a red hot knife. These breast pains tend to get worse and worse in the afternoon and on into the evening and night - climaxing at the middle of the night feeding around 2 or 3am (hence the mommy breakdowns every night). I also notice them more when I am wearing baby and she is pressed up against my breast for long periods of time. (I wear baby a lot as DD1 is all over her every time I set her down!).

Other things I've noticed:
- the pain seems to be worse if I'm more stressed out
- heat seems to help the nipple pain but makes the breast pain worse/ more frequent
- cold seems to make the nipple pain worse
- the cracks (bleeding) on my nipples keep coming and going
- baby seems to be super fussy after every feeding (cries like she is in major pain)
- baby is very gassy, but also constipated

Other notes:
- we co-sleep
- I've tried nursing her in EVERY position
- she has a good latch (I can tell because occasionally she doesn't, and that's a very different sort of pain - like someone is slamming my nipple in the door!)
- baby hadn't pooped for several days, and last night I got her to poop by gently sticking a thermometer with olive oil into her bottom and moving it (very slowly and gently) from side to side for several minutes - the poop was very thick and sticky.
- we don't have any signs of thrush

For the last couple of weeks I've been thinking that it's Raynaud's, but I'm starting to suspect it might be systemic yeast because of the breast pain that is not associated with my nipples.

How do I know??? Who has experience with either of these - can you tell me what it feels like? How did you treat it?

Please help... feeling desperate... won't quit nursing, but so tired of being in so much pain... I want to love breastfeeding!

[rummple]

My son is 13months and I have dealing with similar pain on and off since his birth. In fact I am going to a dermatologist tomorrow morning to rule out yeast. There are so many things it can be according to my lactation consultant. I was just on Le Leche's web site and came across this article http://www.llli.org/NB/NBJulAug99p120.html

I suggest talking to a Le Leche leader and/or a lactation consultant.
I hope it gets better. I will post after my appointment to let you know if seeing a dermatologist was helpful.

Katie

[Mulvah]

Good luck.

Edited by Mulvah - 10/16/11 at 4:33pm

[happydaymomma]

I made an appointment today with my general practitioner, spoke for a long time about the situation with my midwife again, and put a call in to the lactation consultant (whom I've spoken with before).

I'm feeling sad that I never took charge of the situation with my first daughter, as I always wished our bfing relationship was more joyful... My husband just told me that he is glad i'm pursuing a solution as I made everyone miserable the first time around

Trying not to get stressed out right now as the pain is increasing heading into the night... I'm very grateful to know that there are others who understand how I'm feeling. Maybe it will help get me through he night.

[pdxmomazon]

Probably not very helpful, but I had vasospasms when my daughter was younger, and a very similar painful "jalapeno juice into my nipples" experience when she was older. I thought it was yeast and tried gentian violet, but eventually went to my md and got a diagnosis of mastitis. Mind you I never had fever, chills, other "flu-like symptoms" or even red spots on my breasts, but one course of antibiotics solved the problem right away. I have only taken antibiotics twice in the past five years, and both were for cases of mastitis that I thought were thrush.

[3girls1boy]

I did not have the stabbing pains you describe with my last 2 (out of 4, did not have this problem with first two) but I had pains in my nipples that was almost continuous and they were blanched white after baby came off the breast. Tried many treatments for yeast, which did not help with 3rd baby, but just decided to ignore it after about 2 months and the pain went away at about 5 months. With my last child, the pain continued for 6 months even after trying to treat for yeast. Finally, at the suggestion of a lactation consultant, I decided it might be vasospasm and she suggested I take Evening Primrose Oil (fish oil is reported to work as well). I took 12 capsules a day and had some improvement after about 2 weeks and resolution of pain after about 8 weeks. I weaned myself off the Evening Primrose oil (EPO) at that point. My son continued to nurse until he was 4 and the pain would come back ocassionally, especially around ovulation, but I found if I went back on the mega dose of of EPO for a few days, it got better.

If you google around you may still be able to find the paper that outlines this treatment. I believe it was done by to LC in Australia. Hope this helps.

JT, mom to 3 teenage girls and 1 9 yr. old son

[rummple]

So, I went to the dermatologist last week and she wasn't very helpful. She gave me a prescription that was a more powerful than the over-the-counter polysporin (which my lactation consultant recommended) She also prescribed Fluconazole. Basically we are treating yeast but she wasn't even sure if that was the problem.
On maybe a more helpful note. I just read something on dr. jack newman's website that lead me to believe that when yeast is present it can cause vasospasm. (Treatments for Raynaud’s phenomenon (blanching of the nipple)
Identify and Fix the original cause of the pain: i.e. Poor Latching and/or Candida.- this is the only place that I could find a connection between the two, you can find it here-http://www.nbci.ca/index.php?option=com_content&view=article&id=52:va sospasm-and-raynauds-phenomenon&catid=5:information&Itemid=17)
Come to think of it back in June I treated yeast and was pain free for a matter of months. I have found a link between having a plugged duct and the occurrence of symptoms. Anyways, I will be treating yeast and hope that my symptoms disappear. Also, When my symptoms are present my milk supply is low. I have also started taking a supplement of Cal/Mag which is supposed to help the vasospasm as well as let down. I would love to know how you are doing and if you have found any help. Let me know if you have any questions.
-Katie
Wyatt- 13months!

[happydaymomma]

Originally Posted by rummple

On maybe a more helpful note. I just read something on dr. jack newman's website that lead me to believe that when yeast is present it can cause vasospasm. (Treatments for Raynaud’s phenomenon (blanching of the nipple)
Identify and Fix the original cause of the pain: i.e. Poor Latching and/or Candida.- this is the only place that I could find a connection between the two, you can find it here-http://www.nbci.ca/index.php?option=com_content&view=article&id=52:va sospasm-and-raynauds-phenomenon&catid=5:information&Itemid=17)

This was one of the articles that my midwife had both me and the doctor (who is a friend of hers) read before I went in yesterday for my appointment.

I was also surprised to hear about this, as no one had mentioned to me that the vasospasms could be caused by yeast. The most interesting part to me though, was that the yeast (unless it is systemic) can be present without causing any problems, unless you get cracked nipples and the yeast is introduced to the inside of the tissue. Which, of course, leads back to the latch.

All of this has caused me to really re-examine baby's latch and try to really work hard to get it very good - which is proving a lot harder than I thought!

At night, if I nurse her while I'm lying down she doesn't wake up afterward, and we all get a good night of sleep. But I also have a hard time getting her to latch on properly in that position. If I sit up to nurse her though, she wakes up afterward every time, and either myself or my husband spends at least the next hour changing diapers and pacing around trying to get her back to sleep. It's totally a catch 22!

And as for the doctor's appt yesterday, it was pretty much what I expected. He prescribed triple nipple cream to treat any yeast that may be on the surface. And he said to check back with him in a few weeks and if the cream doesn't work he'll prescribe Diflucan. I wasn't expecting him to have any other far out ideas about what it is or how to treat it, mostly I was just in it for the prescription. But he's a real nice guy and is willing to investigate and work hard to figure this out with me, so that's cool.

I think I may start on some probiotics for myself and the baby in the next few days, as soon as I can get to the store

I have to say that my nipples do feel a little better today, but I bet it's more to do with the vigilance toward proper latch than anything else. We'll see how all of this turns out.

Annie

[3girls1boy]

[QUOTE=happydaymomma;15986952]

I was also surprised to hear about this, as no one had mentioned to me that the vasospasms could be caused by yeast."

Any kind of nipple trauma can lead to vasospasm, which will take longer to resolve even after the initial cause is corrected.

"And as for the doctor's appt yesterday, it was pretty much what I expected. He prescribed triple nipple cream to treat any yeast that may be on the surface. And he said to check back with him in a few weeks and if the cream doesn't work he'll prescribe Diflucan."

If it is yeast, it's imperative that baby gets treated as well, or your just going to get it again from the baby. Gentian violet is a mess (and you have to call around to pharmacies to find it, although you don't need a prescription), but reportedly very effective if that is, in fact, the problem.

[happydaymomma]

Does the gentian violet treat both mother and baby, or is it applied in conjunction with the Diflucan?

[MonkeysRUs]

A few quick thoughts:

Has your baby's mouth been checked by someone who is knowledgeable about tongue-tie?

Do you have any history of breast surgery or trauma? Sometimes with chronic pain chiropractic and/or acupuncture can help

There is little evidence to suggest that ductal yeast actually exists. Chronic pain that is not caused by latch issues is often due to a bacterial infection. Your doctor can do a culture or a trial of antibiotics.

[MonkeysRUs]

Originally Posted by happydaymomma

Does the gentian violet treat both mother and baby, or is it applied in conjunction with the Diflucan?

Gentian violet can be used at the same time as diflucan, and it does treat both mom and baby. Paint the inside of your baby's mouth with it prior to nursing, and she will transfer it to you. Remember that if appropriate thrush treatment is not working, it's not thrush! Bacterial infections are often mistaken for thrush.

[aphel]

(nak)

happydaymomma - just wondering if you've had any relief or found any answers? i'm having some very similar issues....

[happydaymomma]

Well, let's see... relief.  Yes, I've had some relief.  But the pain is not gone completely.  I feel like the triple nipple cream healed my torn up nipples, but they are still pretty bright pink and I am still getting occasional shooting pains in my breast.  This pain is often bad enough to keep me from sleeping unless I take some Advil.

My doctor had said to check back in after two weeks, so I did, and he prescribed fluconazole for me and an antimicrobial for my baby.  We'll see if that clears up the rest of my pain.

I also now think that a lot of this got started because of a poor latch, and then snow-balled from there.  And just yesterday I had a friend come over and give me latch advise that I'd never heard before.  I was having a very hard time getting my baby to open her mouth really wide (the word "gape" doesn't ever describe the way either of my babies have opened their mouths to nurse), and she suggested touching my nipple to baby's cheek (the one that is laying down) and baby will instinctively open wide and turn her head toward the nipple.  It works!  She also said to point my nipple toward the top of her mouth.  And now we are having SO much LESS clicking!  It's amazing and great!  I'm thrilled, to say the least.

I will keep posting about how the fluconazole is working.

[aphel]

I've been on flucanozole for over two months. ::sigh:: Hope you get better results than I did! Is your LO being treated for yeasties as well?

Thanks for the latch advice, going to give that a try. DD daughter likes to slurp in my nipple like it's spaghetti. Ouch!

[happydaymomma]

Wow, has it been two years since this all went down?!

In case anyone out there is having these same problems and desperately seeking relief (like I was), I have good news! I did find it, and now have a beautiful and mutually satisfying breastfeeding relationship with my two year old daughter.

Not long after my last post here I went to a lactation consultant who said she was almost certain that my case was Reynaud's. And here's the kicker - Reynaud's is a problem of constricted blood flow (like frost bite - sound familiar sufferers?!), and Flucanazol, the treatment for yeast, is a vasoconstrictor... Bells going off yet? The Flucanazol makes it worse! You need a vasodilator, like niphedapine, to fix you up.

And boy did it ever! After taking it for a month I ran out so I stopped taking it, a little warily, I'll admit. But I have only had one episode since, and it was about six weeks after running out of the niphedapine.

Here's some more info on niphedapine:
http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0000816/

I hope that even though this post is probably too late to help it's original followers, it helps someone out there who is suffering and desperate to solve their nursing woes.

Cheers!
Annie