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Excruciatingly painful breastfeeding - encouragement, advice?

post #1 of 30
Thread Starter 

Our daughter is 8 days old, and from the beginning breastfeeding has been excruciatingly painful.  It's like knives and burning acid on my nipples every time she feeds, and it hurts so much that I can't feed her without crying out.  My nipples are scabbed, and when she spits up, there is obviously blood in it, and I can't wear any clothes against my nipples.  I've been taking advil non-stop since the birth and have seen two lactation consultants, with no improvement.  She is feeding fine - apparently the amount of milk she has been getting at feedings is off the charts for her age, and she is already over her birthweight, so there is no problem with breastfeeding from her end - just the pain that I am having.  Her latch looks good (according to the nurses at the birthing center, and both LCs). 

 

At least one nurse and two different pediatricians have said that it's just normal to have this kind of pain (whatever the books may say about severe pain not being normal) and that it will probably take a month before it goes away.  I'm finding this really discouraging.  I do have a pump, so I could try pumping and feeding her EBM for a few days to give my nipples some time to heal, but I'm really not very comfortable doing that (won't that just make her latch worse and risk messing with my supply? - and will the pump really hurt any less than her latch?).  I have tried all the tips from the LCs and from the LLL book and what I can find online, and none of them make the pain any better, or seem to help my nipples to heal at all.  I'm particularly concerned that now that my nipples are so injured, even if nursing was suddenly perfect, it would still hurt horribly b/c they won't be able to heal with the continued friction and strain of nursing. 

 

I was hoping to find some advice or encouragement here? 

 

Thanks in advance for reading my post!

post #2 of 30

Well, this does not sound like a run-of-the mill nipple pain from beginning nursing to me. However, maybe you have exceptionally delicate skin and so even though her latch is good, this is a major adjustment.

 

I do think it will heal. Here are some ideas:

1. Get a nipple shield. I am not normally a big advocate, but your milk sounds established, and you need a little help in healing. This is a temporary help, not to be relied on for every feeding or for long term--try every third feeding or every other feeding until the pain eases. They are sold at pharmacies and the Target near me carries them (check online?).

2. Go topless. After a feeding, apply your milk to the nipple/areola and let it air dry, then apply lanolin. Do this after every feeding and go topless as much as you can (or a button-up shirt un-buttoned, etc.). Keep applying the breastmilk and air-drying followed by lanolin every time you think of it throughout the day, in between feedings too.

3. Keep calling lc's. It sounds to me like maybe she's not getting the nipple DEEEEP, maybe she is but usually this kind of soreness is from the baby's tongue rubbing the nipple which will not happen if the nipple is deep in her mouth. There are finger-sucking exercises for babies to help them learn to get the nip deeeeep and not rub the tongue with friction. A good lc can help you with this. Keep calling LCs and IBCLCs, something is out of whack here, and hopefully if you keep looking you will find the answer to what is going on.

4. you_tube "breastfeeding nipple twist" there is a video that demonstrates one way to insure the latch is deep; I would give you the direct link but am having trouble getting into my you_tube account

5. do not introduce a bottle-your intuition is right on about this; a bottle, even a so-called "breastfeeding friendly" bottle may confuse her and possible create new latch/suck issues which you do not need right now.

6. if you really really need a break from bf for one session, google "finger-feeding breastmilk" or possibly some mamas here may chime in with successful pointers, or try cup, syringe, or spoon feeding. I would advise not to rely on an alternate feeding method/pumping because breastfeeding takes practice for both you and babe, and each feeding you are both going to be getting better at it. You also want to protect your milk supply and the best way to do this is to keep breastfeeding. I think it can be easy to fall into the expressing and alternate feeding cycle which can be hard to keep up with long term. *eta yeah, the pump is gonna pull your nipple anyway like you said so might as well just bf* that's JMO

7. I know the lc's you worked with said she has a good latch, but is her mouth wiiiiiide open like a big yawn? The tongue will be different from a yawn, but that is about how open the mouth should be. Is her chin touching your breast? Are you tummy to tummy? Sitting up straight with lots of pillows supporting you and baby and making sure not to hunch down---the hunching (I am totally guilty bf huncher) can cause baby to pull on the nipple, maybe that's a factor?

 

hug2.gif I believe this will be just a temporary rough spot for you and your baby to overcome and that you can do it! You are making such a great choice by sticking with bf, major major hugs and kudos to you.

 

I hope this helps and that you get some more really great tips from the wonderful, knowledgeable mamas here.

 

Please keep us updated, I am wishing you healing and rest and pain-free milky times!

post #3 of 30

Has your baby been checked for tongue tie or unusually high palate?

 

Also, if you can vary your nursing positions, this might help a little since it varies where the pressure is on your nipple.

 

Look up Dr. Newman's recipe for "All Purpose Nipple Cream"  Sometimes you can get a compounding pharmacy to make this up for you, but I believe there is also a version that can be made from over the counter creams (basically, I believe it includes antibiotic, anti yeast and analgesic properties).

 

I really hope you are able to work through this.  Applied heat after nursing may help.  Take it one day, or one feeding if you need to, at a time.

 

Peace

post #4 of 30

You're getting some great advice from the other ladies.  I just wanted to chime in to tell you that no, that kind of pain is not normal.  It is normal to have pain at the moment when the baby latches, but not on and on through the feeding.  

post #5 of 30

You might try posting on FYT for a recommendation for a Great! LC. You can also try calling your pediatrician-- quite often they may have a recomendation for an LC or might be able to perscribe something for the nipple soreness.

post #6 of 30
Thread Starter 

Thanks so much for your replies, everyone.  I really appreciate the help.  Thanks in particular to craft_media_hero for all of your detailed advice. 

 

The LCs that I've tried both came highly recommended - I guess that perhaps I need to be more assertive in going back for more help.  They both worked on my latch, but it didn't really hurt less even when they latched her on themselves, so I'm not sure how to get her to latch on "better."  As far as I can tell, she has enough of the nipple in her mouth, and it is the right shape when I take it out. 

 

I have been basically walking around all day with my shirt unbuttoned, and I have tried expressing a little milk and letting it dry, and then applying ointment (I haven't used lanolin b/c I'm allergic to wool, but I've been using the Earth Mama Angel Baby ointment that came recommended on online boards from other moms with a wool allergy).  This hasn't seemed to make any difference though, other than the fact that the ointment at least keeps the air off the nipples, which reduces the burning when I am not nursing. 

 

I have read elsewhere that changing the nursing position may help, but I'm a bit nervous to try this - I have been focusing so hard on trying to get the latch "right" in the standard position (using a my brest friend pillow plus lots of other pillows/towels for propping her into the exact right position), that I don't know how to make other positions work.  I was originally trying lying down nursing at night, but had to quit b/c it became even worse than the other position.  The nipple pain for some reason seems to be the worst at night (but this is true also with the standard sitting up position), so maybe it wasn't the position that was the problem, but I just can't tell. 

 

In fact, if I just let her latch on however, it doesn't seem to make a difference - it seems that almost all latches hurt the same amount.  I've tried massaging the breast while she feeds, and also supporting the breast in various holds, and I'm not sure that this doesn't make things worse...

 

The LCs did check her for tongue tie and didn't seem to think that was an issue (or if it is, it is very minor).  She may not be sticking her tongue out enough, so we have been doing tongue exercises, but I just can't tell if I'm doing them correctly, and they don't seem to be helping.  No one mentioned anything about a high palate - it doesn't look high to me, but I have no idea what is normal for a newborn. 

 

Thanks for the recommendations on the nipple twist - I will try this next time I feed and see if it helps.  Thanks also for the cream recipe recommendation - when the pharmacies open on Monday, I will try to obtain some of this asap.  I have wondered about thursh since I have always been prone to yeast infections and I had to have IV antibiotics during delivery b/c of positive strep B results, but neither LC mentioned it as a possible cause and the baby doesn't have any symptoms, so I'm not sure if I should push to see if this could be the problem?

 

I had a nipple shield from a friend and I tried using it this morning while nursing.  The first time I tried it it didn't seem to help the pain, but the second time it did seem better.  I'm nervous, however, that with the nipple shield she isn't getting enough, so I kept putting her back on the breast when I used it today and feedings took twice as long.  It's worth it though, if it can stop the pain - I just know that a lot of people say nipple shields are a huge mistake, so they make me nervous.  But at this point, I just really, really want the pain to improve.  I also received a pair of Ameda hydrogel pads today that I had ordered after seeing some positive recommendations on the web, so I'm wearing those now to see if they help the nipples to heal a little. 

 

I'll post updates if anything changes.  In the meantime, if anyone else out there has further encouragement or advice, please feel free to continue posting!

Thanks again, everyone, for taking the time to reply to my post!

post #7 of 30

cww, you are amazing for sticking with this through the pain, and it sounds like you're doing everything you can to continue breastfeeding your baby!

 

I would normally agree about nipple shields, you are right that the feeding will take longer and there is less stimulation to your milk supply---they are meant to be used as a temporary solution to an acute-type problem, and it sounds like that's what you are going through. Maybe only use it when the soreness is really really unbearable or for the night feedings and just until you get a chance to heal up a bit. Hopefully this will only last a couple of weeks or so.

 

Most importantly, though, listen to your intuition because you seem to be right on in all of this; so if your mama gut says no N/S, then that's okay, too.

 

I am so sorry that you are going through this; I hope it gets better for you soon.

post #8 of 30
Thread Starter 

I just thought I'd post an update.  I wrote the LC yesterday and she said that my symptoms sound like yeast.  I mentioned that our daughter didn't have any symptoms and she said that she rarely sees symptoms in the baby.  So I'm calling my midwives first thing in the morning to see if they can call in a prescription or if they need to see me, to make an appt.  I'm hoping that will solve the issue, especially since everything I can tell about her latch seems good. 

 

In the meantime I've still been using the nipple shield, which I'm not nuts about.  I am worried about her getting enough and about my supply, but at this point my nipples burn so much all of the time that it is the only way I can stand breastfeeding.  Even with the shield it still hurts a bit, but the really bad pain seems to subside with the shield after a minute, whereas without the shield it burns and stings so badly the entire time.  I had an unmedicated birth, and I would say that the nipple pain with breastfeeding has been more painful than the birth itself, so I'm really hoping that yeast is the correct diagnosis and that it clears up relatively easily with treatment. 

 

I feel a little stupid for not pushing the yeast diagnosis earlier, since I always have problems after being given antibiotics, and since the antibiotic they gave me in the hospital was a pretty strong one, since it was the only remaining option to which the strep tested sensitive and to which I didn't have a history of allergy/adverse reactions.  If treatment clears this up, I'll repost again and let everyone know how it turns out!

 

Thanks again for your advice and encouragement!

post #9 of 30

hug2.gif

 

I hope it's yeast and the treatment takes care of it!

 

If you are still in pain after the treatment, you may want to think about getting even a 'minor' tongue-tie released. They can be real killers to the nipples.

 

And here is a great info sheet on yeast that may help too: http://www.nbci.ca/index.php?option=com_content&view=article&id=12:candida-protocol&catid=5:information&Itemid=17

post #10 of 30

reynauds syndrome?

post #11 of 30

I had Reynauds syndrome with my last two babies and in my experience, most of the pain came after the feeding, not during.

 

Gentian violet can clear up thrush in a matter of days.  It's very messy (will stain your bras and your baby's mouth and tongue purple--your baby looks like a "goth" baby).  You don't need a prescription but it's kept behind the counter and you need to call around pharmacies to see if they have it.  If you want to try this, look up the treatment course under Dr. Jack Newman's information.

post #12 of 30

Hi!  I just saw your post about trying a nipple shield, and that's what I would have suggested to you!  I had the same horrible pain/cracking/bleeding with both of my boys, and I ended up using a shield myself.  I ended up using one the entire year I breastfed my first son (I didn't know they were meant to be temporary), and am on the same track with my nine-month-old (at this point, it works well for us, so I didn't bother weaning him from the shield).  Don't worry too much about your supply...recent studies show that the new ultra-thin contact nipple shields (like Medela) don't cause a significant decrease in milk supply.  I never had any supply issues (except oversupply), and usually when you hear people warning against using nipple shields their information is related to the old style of shield which was thicker and didn't give enough stimulation to keep supply up.

 

I also try to tell any mom who uses a nipple shield about Shield Shells to store their shields in.  I actually have more than one - I keep one in my diaper bag at ALL TIMES, plus a couple around the house so I don't have to search for one with a crying hungry baby! :)  The Shield Shells are great...they keep my shields clean between feedings, plus I don't lose them, since they are brightly colored.  They also stay safe from my dog and two-year-old in there.  They are sold online at www.shieldshell.com.

 

Hope that helps!

 

Quote:
Originally Posted by cww View Post

I had a nipple shield from a friend and I tried using it this morning while nursing.  The first time I tried it it didn't seem to help the pain, but the second time it did seem better.  I'm nervous, however, that with the nipple shield she isn't getting enough, so I kept putting her back on the breast when I used it today and feedings took twice as long.  It's worth it though, if it can stop the pain - I just know that a lot of people say nipple shields are a huge mistake, so they make me nervous.   

post #13 of 30
Thread Starter 

thanks for the additional advice and recommendations, ladies.  (Indymom, thanks for sharing your experience with the nipple shields - this helps to take some of my anxiety about them away, and they've been a real lifesaver for me this last week.)

 

I thought I'd post a quick update - I started by doing some vinegar rinses (1 T vinegar in 1 c water after each feeding) and using over-the-counter miconazole cream, until I got a prescription from my midwives on Tues morning (this was a combo cream that sounds like the one a pp recommended, with nystatin, bactrin, and a couple of other ingredients including an anti-inflammatory) - after a couple of days, the worst of the burning did seem to improve, and now that it's been a week, the burning pain is much better, although my nipples are still a bit sore, even just exposed to the air.  I've been using the nipple shield all week (the pain was just so bad without it that I couldn't bring myself to go without it again), and I'm hoping to try nursing without it again soon.  Nursing sessions do seem to take a lot longer with the shield, but our daughter does otherwise seem to be getting enough to eat, so I'm trying not to worry about supply issues for now.  I think I can also tell the difference between latch pain now and the thrush pain - when she isn't latched on correctly, the pain is more of a pinching pain, whereas the thrush pain was more like a burning pain directly on the nipples.  What I don't know is if our daughter is also doing something with her tongue to hurt my nipples (in addition to the pain from the thrush itself) - I think the nipple shield prevents me from feeling this if that is the case.  I guess I'll find out when I try nursing without the shield again. 

 

The good news is that with the shield and the improvements in the thrush from the cream treatment, nursing is fine for now, so that's a real relief.  My poor nipples could still use a bit of improvement, but the current discomfort is manageable, and I hope, temporary.  Thanks again to all of your for your advice and reassurance!

post #14 of 30

You probably have thrush in your nipples.

 

Try soaking your nips in a bit of white vinegar and warm water a few times a day. The pain will get slightly worse, then get better. Don't use moisturizers like lansinoh if you do have thrush. It will makes it so much worse.

 

Reading your posts make sme cringe in rememberance. It hurts, alot. The pain is not normal.

post #15 of 30

I just wanted to offer some encouragement grouphug.gif. It sounds like you are doing a great job, and believe me, it gets so much easier.

 

I started taking probiotics when I had thrush (6 pills a day until the thrush was gone and then 2 pills a day since then) and I think they help to keep the yuck flora away. I also did water/white vinegar rinses after each nursing session, and only used my towels once, then all of the linens got washed in hot hot water with vinegar in the rinse. Make sure that you're regularly sterilizing that nipple shield and any pacifiers, too (you can use a microwave steam bag or bottle sterilizer or just boil them on top of the stove for 15 minutes). I did that about twice a day.

 

Also, just homemade all-purpose nipple ointment helped me (equal parts cortizone, lotramin, and neosporin) applied with a clean q-tip as often as I remembered after nursing.

 

I used a nipple shield for the first six (?) weeks (I think -- at the time it seemed very, very important, but now I've forgotten) and even though I was kind of stressed out about it the whole time, it did not affect my supply during that time. I did take my daughter in for a weight check at 1,2,3, and 6 weeks (like I said, I was paranoid about it), but she gained beautifully.

post #16 of 30
Thread Starter 

Thanks for the additional encouragement, everyone.  I really appreciate it. :)

 

I just thought I'd update.  One of the LCs referred me to a lactation doc, who I've been working with.  Apparently I have at least one inflamed duct, which we are treating with Advil, and which seems to be improving, which is also triggering vasospams, which apparently feel better if kept warm (so all that walking around without anything on my nipples was actually making that worse).  However, the side without the obvious inflamed duct still gets painful very quickly if I nurse more than once without the nipple shield, so there is still something else wrong.  Yesterday the L doc put me and the baby on Diflucan for two weeks - she said that if it is indeed yeast, it should improve within 5 days, so we'll see if that helps. The topical cream alone on my nipples didn't improve things a few weeks ago, so we'll see what happens. 

 

I'd say that right now nursing with the nipple shields is still uncomfortable to painful, but manageable (and sometimes on my uninjured side it actually doesn't hurt at all).  But nursing without them for more than a single session is just excruciatingly painful.  So that's progress in that we can function, but just no real resolution yet. 

 

Now the LO isn't gaining weight well anymore, so we have a whole other thing to worry about - ug! :(

 

Thanks again for your encouragement and advice.  I hope I'll be posting here again soon with a happy resolution. :)

post #17 of 30

Oh big hug to you!

post #18 of 30

I have had a lot of your same issues with my son's latch (plus low milk supply, arg!) and using a nipple shield was the only way I could keep nursing him.  I was in agonizing pain and the nipple shield makes nursing bearable.  I am now pumping full time and nursing him about once/day because my nipples are STILL healing.

post #19 of 30

hug2.gif

 

GOOD FOR YOU TO KEEP NURSING YOUR BABY!!!!

 

I wish I had more advice than any of the previous posters but everything I would have said has already been said! I just wanted to offer words of encouragement to you, I've been there and it's tough - but you can make it through!

post #20 of 30

Good for you for sticking with things even through these challenges!

 

I also had cracked/bleeding nipples, which developed into excruciating nipple pain. When DD latched on, it felt like a knife going into my breast. Sometimes the pain would be bearable while nursing, other times not. It wasn't a latch or supply issue. I tried a bunch of "natural" remedies. I had an excellent lactation consultant who recommended a general practitioner who specialized in breastfeeding issues. We started with the theory that it might be thrush, but the medication she prescribed for me had absolutely no effect. So she started me on a series of antibiotics, because apparently sometimes mastitis can manifest as intense nipple pain. 

 

It took 12 weeks & 4 rounds of antibiotics, but we finally found one that cleared up the infection. It was amazing...after so much pain and trying so many things, within 48 hours the pain just disappeared. Suddenly I understood why women like nursing!!! And my DD is now 29 months old and still nursing.

 

Very few physicians know anything about lactation issues, so I feel like I lucked out by finding one who could help me. I had to drive a hour to get to her office, but in the end it was worth it.

 

My experience may have no relevance to your situation, but I thought I'd share because until I had the problem, I wasn't aware that mastitis could show up primarily as nipple pain. I occasionally had a blocked duct, but otherwise, I didn't have any of the "classic" mastitis symptoms. 

 

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