Excruciatingly painful breastfeeding - encouragement, advice? - Page 2

[cww]

Thanks again for the responses, everyone.  It's really helpful to get encouragement and to hear your specific advice and experiences.  We've tried 2 weeks of oral diflucan (both me and the LO), and while it cleared up her diaper rash (which looked like yeast) and improved some of my enduring digesting symptom that had persisted since the antibiotics during labor, the nipple pain is no better.  But it might be pump trauma, since my LO was not gaining enough weight, and I had to pump after every feeding for a week to get her weight up.  I'm now still pumping twice per day, and hoping to get her to drink more efficiently so that I can drop the pumping (unless I'm trying to prepare something to go out).  Now the doc has me supplementing the topical Nystatin cream that I've been using with clotrimazole to see if that makes any difference.  I also tried grapefruit seed extract in water as recommended by one of my midwives who had the same issue with her first son, but so far that hasn't made any difference. 

I've had a bunch of plugged ducts this last week (maybe as a result of taking herbs to boost my supply in the hopes that that will make the milk flow faster and my LO nurse more efficiently at the breast?).  I hadn't had those before, so I'm not sure if that could be related to the extra pumping somehow.  I woke up this morning with incredibly painful engorged breasts (for some reason, the LO hasn't really been feeding much at night for the last 3 days) which I've never had before, and despite applying heat before pumping/feedings, taking Advil, and massaging the areas before/during feeding/pumping, it's still painful.  If it doesn't, I'll give the lactation doc another call. 

Thanks Cl mama for sharing your story.  I've been wondering if the failure to respond to yeast treatments could mean that it is some other type of infection.  If the further yeast medications don't have any effect, I am definitely going to raise this possibility with the doc.  It sounds like once we can actually determine exactly what it is, it is likely that it could clear up quite quickly with the right treatment. 

I'm hoping to post again soon that I've finally found a resolution...  Keep your fingers crossed for me! :)

[CI Mama]

Thanks for the update & do keep us posted on your progress! I hope relief comes soon.

My sister just had a baby 5 weeks ago and she's going through the same thing...persistent nipple pain even though there's no latch  or positioning issue. She's doing the anti-yeast meds right now, but so far no relief. I think the nipple pain issue is common...and I wish it was easier to get clear diagnosis & treatment!

Good luck!!!

[gemasita]

I was diagnosed with thrush but after not getting any better, went to a BF-friendly dermatologist who did cultures and it came back positive for a staph infection.  I'm still not pain-free but seem to be getting a little better.  I wonder how much is pump trauma too...I pump every 2-3 around the clock except for one stretch at night.

[OSUvet]

I don't have any other advice than what you've had, OP, but I wanted to post that I am going through something similar and commiserate a bit. I nursed my baby with pain similar to what you've described throughout every feeding for 3 1/2 weeks. I still have open oozing/bleeding sores on both nipples and cried at most feedings. I kept thinking it would get better like everyone said, but it was getting worse despite everyone saying that his latch looked good. The pain just kept getting worse and I developed a stabbing pain that radiated to my armpits which the LC said was likely inflammation of the nerves due to repeated trauma.  I finally saw another LC who recommended a break (pumping and bottle feeding) since I was obviously in such pain. I really did not want to do this, but felt I was at a point where I could not continue. I tried the nipple shield against the LC's advice and it really didn't help with my pain. I finally was able to determine that the main problem is that baby clamps down with his gums on my nipples, hard at latch-on and then pinching with each suck, occasionally clicking (breaking suction) and clamping down harder throughout the feeding. So the latch looks good from the outside, but baby is basically chewing on me while sucking. He does not seem to be tongue tied. For the past 5 days I have been nursing him only a couple times a day because otherwise the sores stop healing and continue getting worse. Our LC is also a craniosacral therapist and is working to relax him and correct his suckle. Anyway good luck to you, OP. I hope we are both able to enjoy nursing our LO's soon!

[homemademom]

Originally Posted by OSUvet 

I don't have any other advice than what you've had, OP, but I wanted to post that I am going through something similar and commiserate a bit. I nursed my baby with pain similar to what you've described throughout every feeding for 3 1/2 weeks. I still have open oozing/bleeding sores on both nipples and cried at most feedings. I kept thinking it would get better like everyone said, but it was getting worse despite everyone saying that his latch looked good. The pain just kept getting worse and I developed a stabbing pain that radiated to my armpits which the LC said was likely inflammation of the nerves due to repeated trauma.  I finally saw another LC who recommended a break (pumping and bottle feeding) since I was obviously in such pain. I really did not want to do this, but felt I was at a point where I could not continue. I tried the nipple shield against the LC's advice and it really didn't help with my pain. I finally was able to determine that the main problem is that baby clamps down with his gums on my nipples, hard at latch-on and then pinching with each suck, occasionally clicking (breaking suction) and clamping down harder throughout the feeding. So the latch looks good from the outside, but baby is basically chewing on me while sucking. He does not seem to be tongue tied. For the past 5 days I have been nursing him only a couple times a day because otherwise the sores stop healing and continue getting worse. Our LC is also a craniosacral therapist and is working to relax him and correct his suckle. Anyway good luck to you, OP. I hope we are both able to enjoy nursing our LO's soon!

I would suggest getting someone knowledgeable about posterior tongue tie to look at your baby.  I thought the same as you, that he wasn't tongue tied, but my guy clamped and chewed, too. The frenulum seemed so minor that no one imagined it could actually be impairing the way the baby latched. Plus, his suck was good, so it seemed even less likely. Long story short, his small posterior lingual frenulum really WAS a problem. It was amazing how much he used his tongue after the laser procedure.  See these pictures and do some of the tests to see what your baby does: http://www.cwgenna.com/qhcontent.html#tt 

[cww]

Hi everyone,

I just thought I'd update - I've tried several times over the last few weeks but kept getting error messages when I tried to post. 

I've been through about 5 different creams and oral treatment (both me and the LO) for yeast with no results.  I asked the doctor if we could try a culture, and that came back positive for some kind of bacteria which is mainly susceptible to penicillin (which I'm allergic to) and clindamycin (which I've had an adverse reaction to in the past that means I can't take it orally), so we tried a topical application of the clindamycin for 10 days, which didn't help.  The doctor came for a home visit again today, and she cultured my and the LO's mouth to see if it still seems to be there.  In the meantime, she's given me meds for vasospasm (which I'm still having, but which I think is a secondary problem caused by some yet-to-be undiagnosed primary issue), and she wants me to try putting Mylanta on my nipples after feedings, in case there could be an acid reflux issue.  She has thought all along that perhaps the LO has acid reflux (but I'm not sure that her symptoms are atypical for a newborn?).  I'm hoping that the culture shows something again that might explain the pain, since that seems the most reasonable and treatable possibility...

The pain has been there from day 1, and hasn't really changed in nature at all.  I can keep it to a manageable level if I always feed with the nipple shield, but if I go even once without it, even for just part of a feed, it's like the trauma from that is strong enough to start to bring back a much stronger pain that persists even when I'm not feeding.  When I was going without the shield in the beginning all the time, it was just excruciatingly painful.  So I'm grateful to have the shield, since it's made it possible to keep bfing, but even with the shield things still hurt somewhat, and the pump is always uncomfortable.  :(

The lactation doc says I am an unusual case, but that even with unusual cases, they are almost always able to find a solution, so I am keeping my fingers crossed.  I will keep updating here, with the hope that maybe someone else can benefit from all my trials and errors... :)

(The doc did check the LO for tongue tie again, and she says that she does not have it at all at this point, so that does seem to rule that out completely as a cause...)

[gemasita]

Oh my gosh, I am in the same boat as you.  Pain since the beginning (and we are at 9 weeks now), while feeding, while pumping, inbetween feedings and pumpings too.  Knife-like pain in my breasts and nipples.  Treated for thrush and staph.  No change.  The thrush treatments and boiling of all pump parts and bottles about drove us insane.

I'm in NC and the University of North Carolina is doing a study on unresolved pain while bf/pumping that I am going to try to get into.  My LC (who is awesome), says I am atypical too, except that she occasionally comes across people who describe their pain like mine.  Mine doesn't seem tied to anything like full breasts or letdown - it's very random.  I use a topical anti-inflammatory but it doesn't help.  I mainly just self-treat with 800mg ibuprofen every 8 hours.  But I still have very high-pain days and then low-pain days.

I only pump at night now (as of a few days ago).  I think there was just a lot of pumping trauma.  My babe now causes less pain nursing than the pump!  That's WITH the nipple shield but who cares if I have to use that forever at this point!

I have low milk supply and it's almost like my body is trying to produce milk all the time and it's just not able to do it and that is causing my pain.  I don't know - that's my theory.  My nipples are black after I pump too - must be some vasospasms going on there but I, like you, think that is secondary.

[OSUvet]

Originally Posted by homemademom 

I would suggest getting someone knowledgeable about posterior tongue tie to look at your baby.  I thought the same as you, that he wasn't tongue tied, but my guy clamped and chewed, too. The frenulum seemed so minor that no one imagined it could actually be impairing the way the baby latched. Plus, his suck was good, so it seemed even less likely. Long story short, his small posterior lingual frenulum really WAS a problem. It was amazing how much he used his tongue after the laser procedure.  See these pictures and do some of the tests to see what your baby does: http://www.cwgenna.com/qhcontent.html#tt 

Almost 3 weeks of pain  later I am finally following this advice, after being told by my LC/CST weeks ago that my son probably wasnt tongue tied. After some more research and inspecting my son's mouth carefully, I am not only very very suspicious of a type 3 posterior tongue tie, but I also discovered that he has a significant upper lip tie. We are seeing a knowledgeable dentist Monday morning for examination and hopefully correction. 

I just wanted to say hang in there, OP. I think I have found my answer, and I would have given up long ago without the support of many wonderful mamas around me. I hope you find a cure for your pain soon!!

[JLomama]

I am so sorry to hear of all you have been through because we just want to enjoy our babies and nurse pain free! I went through this with my first son and now have been going through it with my third. I posted a thread about treating thrush with coconut oil.  It sounds like a lot of you are dealing with yeast (I could be wrong but the way it is described is exactly what I've been experiencing). I don't think that a lot of the medical treatments for thrush work very well, at least not for us. I was also going insane pumping, feeding, boiling everything, etc. round the clock. So I stopped. I started nursing again and using coconut oil and that has helped us so much. I'm not even giving the baby his probiotic anymore. I rub the oil inside his mouth and I use it on myself. It is good to take as a supplement as well (as long as it's the high quality organic coconut oil, not the cheap stuff you can buy in the store). Apparently coconut oil has fatty acids that are anti fungal and anti bacterial, so you may want to give it a try. It may just help! My son had a bad diaper rash which is almost gone now since I used the oil on him. Hang in there!  You should be proud of yourself for being so determined because so many women would have given up!

[cww]

Thanks for the encouragement, everyone.  gemasita, I hope that you are also able to find something that works.  At least I don't have low supply - if anything I have quite high supply (even though the LO was not gaining much weight for a good 5 weeks starting a week or two after she was born - we still haven't figured that out - I just pump and give her an extra bottle every day, and that seems to have solved it...).  Even though my supply is high, the BF doc had me take fenugreek (three 650mg capsules three times per day), with the idea that increasing my supply further would increase the milk flow rate (the LO wants to nurse for over an hour every time, and with the weight gain issue it seems she is somehow not getting milk out efficiently?).  It definitely kicked up my supply gradually over a period of several days, so if you haven't tried that for the supply issues, you might think about that. 

I'm a bit discouraged.  The most recent culture (my nipple, with a drop of milk, and second of the LO's mouth) came back negative.  So the bacterial infection has cleared up, but there is no change in my pain.  Now I've been taking a blood pressure medication that is supposed to help with the vasospasms, but it has been triggering daily migraines (and yesterday I threw up several times and felt wretchedly nauseated - food poisoning, or a response to the medication?), so I'm not sure that I will keep taking it.  The doc says that I could try doing tylenol with the medication for a few days, but that the headaches should go away after 3-4 days of taking it.  But I don't want to risk spending all day throwing up again - I'm hoping to hear back from her about whether it could have been the medication.  But I also still think the vasospasms are secondary - I still get this burning pain during feedings that has nothing to do with vasospasms, and my letdown always seems to burn and tingle painfully.  If I go without the shield even for part of a feeding, I have much stronger pain afterwards that persists for days. 

The doc says my symptoms don't sound like yeast, since the pain starts after even just a few minutes feeding without the shield (apparently yeast pain takes several feedings to kick in?) - it also doesn't look like yeast visually, and it improved not one whit from about 4 different topical kinds of antifungals and one course of oral diflucan.  I'm a bit depressed b/c all this doc does all day is treat BFing women so I can't imagine anyone with any further expertise, but it seems we've already run through the things she knows how to do.  She hasn't given up on me yet, but it feels like the things we are trying now are more just random shots in the dark.  Right now I am also putting Mylanta on my breasts after feedings, in case she has acid reflux that might be causing the pain, but I'm not sure that this has ever helped anyone before - it feels like a long shot. 

Thanks again for listening everyone...