so frustrated

[loonar]

Maybe this is just a vent. I'm going to see my awesome LC as soon as possible.

For the past 2+ months (my son is 8 months old) I have been getting recurrent plugged ducts on one side. Like every day. I feel like all I am ever doing lately is working out a plug. It's not always the same duct. Some of them are really stubborn and excruciating. Honestly I feel like I am constantly about 10 minutes away from a mean case of mastitis. It all started with a milk blister, which still keeps coming and going, and my nipple is just really damaged and inflamed now. It hurts like hell to nurse on that side. Every few days I am pumping bloody milk.

I have tried (and continue to try) every single recommendation on kellymom and from my LC, for both blisters and plugged ducts. Lecithin, grapefruit seed extract, dietary changes, epsom soaks, hot compresses, olive oil, you name it. I'm going braless at home and wear a loose-fitting sleep bra when out. No side or stomach sleeping. No purses, bags, carriers. Frequent nursing, hot baths, shower stream aimed at the lump... I could go on and on. As for rest, I just got done with a 10-day vacation during which I did almost nothing besides lounging in bed and nursing, with absolutely no improvement in my symptoms. I have been using APNO on the nipple. I have been through two courses of different antibiotics -- both times things got better at first, and then worse again. 

The results just came back from my milk culture and it was totally negative. Blood test also showed I'm not anemic. What on earth is going on? What am I missing? What am I doing wrong?

For the sake of my poor nipple I really want to exclusively pump on that side for awhile... I am crying through feedings just like in those early weeks of tongue tie and thrush... but that's just not an option because the pump could never keep the plugged ducts at bay. 

Argh.

Thanks for reading. 

[Marissamom]

hand expression? has helped me with plugged ducts

[Heba]

Has your LC mentioned the possibility of ultrasound treatments?  Jack Newman and Edith Kernerman suggest that it may prevent recurrent blocked ducts that occur always in the same part of the breast (http://www.nbci.ca/index.php?option=com_content&view=article&id=7:blocked-ducts-a-masti).

 

[foreverinbluejeans]

Pumping can cause plugged ducts. I think that would be the worst thing to do. You can slowly wean from that breast and use only the other breast. You can wean by cutting back on nursing or hand expressing.

You don't always have to "work out" a plug. You could have caused damage. If you are always working out a plug you could be causing repeated damage.  

APNO can cause sore nipples. It sounds like your poor breasts and nipples have had too much done to them. If one breast is ok I would nurse using that one and hand express the other for comfort until it gave little to no milk. Once it healed you could try that breast again or not. You can breastfeed just fine using one breast.

Avoid using anything, pumping, or doing anything to the other breast to keep that one good.

[newmamasara]

Oh loonar  - I can relate!  I am breastfeeding my first child, now 9 months - and only one month out of the last 9 has been pain free.  I am still not 100% pain free but what has significantly decreased my pain was the realization that I'm suffering from vasospasm and not thrush.  I've been taking prescription medication for the vasospasm and when I take it I have much less pain, and when I don't take it the pain is miserable.  I have seen 3 doctors and 6 lactation consultants in my quest for a cure and have written and received emailed help from Dr. Newman. His writings are what finally pointed me in the right direction.  I too have one breast that is worse than the other, with deep breast pain so intense I thought I was always a step away from mastitis.  I too took fluconazole orally and applied APNO for months, applied olive oil, grapefruit seed extract rinses, salt water soaks, diet change, etc. and it was when I stopped the APNO, and stopped everything else but started the nifedipene that I finally found some relief.  I know that I have had thrush before, but that is not the main problem and I know that I've been treated for it repeatedly when I probably didn't have it at all.  My thrush cultures came back negative too (although that doesn't always mean you don't have thrush).  My baby has never acted like or looked like he had thrush. I finally (light bulb moment) noticed that my nipple was completely white, or blanched after nursing and then it would turn beet red as the blood returned to the nipple.  I noticed that warm-hot showers were the only thing in my day that felt good. My pain was constant. Before, during, after nursings - I'd cry through them - clench my fists - to me the pain felt like yeast too but I couldn't figure out how I could possibly have a yeast problem when me or my baby didn't have any other symptoms.  I think I had thrush first, and repeated nipple damage second, and I think I developed vasospasm from all the trauma to my nerves along the way. I don't know if vasospasm could be what you're suffering from but it can be caused by trauma, both physical and emotional - and my doc (ob) had never heard of it.    My LC had to convince her to write me a prescription to give it a try, since nothing else was working.  Our poor breasts-  they're not supposed to feel this way! I hope you get the help you need - I emailed Dr. Newman and he wrote me back with very helpful information that I passed on to my LC and doctor.  We are our own best advocates, since unfortunately there's a huge disconnect between who knows how to help us and who can actually help us with our breastfeeding problems.  Your story is different than mine of course, but I wish someone had mentioned vasospasm (and not just thrush) and really talked to me about it the first month I was in pain instead of 8 months later.  

[loonar]

Thank you so much to all of you for taking the time to reply. 

Originally Posted by newmamasara 

Oh loonar  - I can relate!  I am breastfeeding my first child, now 9 months - and only one month out of the last 9 has been pain free.  I am still not 100% pain free but what has significantly decreased my pain was the realization that I'm suffering from vasospasm and not thrush.  I've been taking prescription medication for the vasospasm and when I take it I have much less pain, and when I don't take it the pain is miserable.  I have seen 3 doctors and 6 lactation consultants in my quest for a cure and have written and received emailed help from Dr. Newman. His writings are what finally pointed me in the right direction.  I too have one breast that is worse than the other, with deep breast pain so intense I thought I was always a step away from mastitis.  I too took fluconazole orally and applied APNO for months, applied olive oil, grapefruit seed extract rinses, salt water soaks, diet change, etc. and it was when I stopped the APNO, and stopped everything else but started the nifedipene that I finally found some relief.  I know that I have had thrush before, but that is not the main problem and I know that I've been treated for it repeatedly when I probably didn't have it at all.  My thrush cultures came back negative too (although that doesn't always mean you don't have thrush).  My baby has never acted like or looked like he had thrush. I finally (light bulb moment) noticed that my nipple was completely white, or blanched after nursing and then it would turn beet red as the blood returned to the nipple.  I noticed that warm-hot showers were the only thing in my day that felt good. My pain was constant. Before, during, after nursings - I'd cry through them - clench my fists - to me the pain felt like yeast too but I couldn't figure out how I could possibly have a yeast problem when me or my baby didn't have any other symptoms.  I think I had thrush first, and repeated nipple damage second, and I think I developed vasospasm from all the trauma to my nerves along the way. I don't know if vasospasm could be what you're suffering from but it can be caused by trauma, both physical and emotional - and my doc (ob) had never heard of it.    My LC had to convince her to write me a prescription to give it a try, since nothing else was working.  Our poor breasts-  they're not supposed to feel this way! I hope you get the help you need - I emailed Dr. Newman and he wrote me back with very helpful information that I passed on to my LC and doctor.  We are our own best advocates, since unfortunately there's a huge disconnect between who knows how to help us and who can actually help us with our breastfeeding problems.  Your story is different than mine of course, but I wish someone had mentioned vasospasm (and not just thrush) and really talked to me about it the first month I was in pain instead of 8 months later.  

This is really interesting. I do have blanched nipples after feeding or pumping, and they randomly turn blue-grey throughout the day, so I had thought of vasospasm. But the pain I'm having isn't associated with any of the color changing. I'm also not sure that vasospasm would explain the bleeding, and the obvious milk blisters? I'm so sorry you've had such a rough go of it, too.

I have begun to suspect my problems are related to a gluten intolerance. I knew already that my body was struggling with gluten -- I had quit it entirely last spring because I was getting debilitating abdominal pains whenever I ate it, but I let it creep back into my diet when those symptoms subsided. A week without any gluten and my breast symptoms disappeared entirely. But now they are mysteriously back, even though I'm still being very careful to avoid gluten. So I continue to be baffled. 
 

To the poster who suggested that pumping is contributing to my problem, ditching the pump is not an option for me as I work outside the home. I'm also not sure I agree that a clog doesn't need to be worked out. When I don't aggressively work out a plugged duct, I begin to get symptoms of mastitis. I don't see how allowing a plug to progress to infection could possibly be a good choice. Perhaps I'm misunderstanding you? 

[tincia]

This isn't at all helpful to you, but I too am relating to a lot of your story, and frequent milk blisters(fortunately not the large lumps though)..i've read about and tried a number of "remedies" but haven't found them to work..my dr is clueless when it comes to breastfeeding, and we don't have an lc in our community..just wondering if your lc was able to give u any useful info/advice?

[Heba]

It does sounds as if the trauma might be being caused by an attachment issue or the pump.

If you do think that your problems may be pump-related, might you consider hand expression?  I know it's not the first option many of us think of (I know I went straight to a pump, which worked well for me), but some women do in fact find that they respond better to hand expression than a pump.  Given that it may be causing you this much pain, it might be worth learning and practising hand expression.  If you do want to try it, a couple of links you might find useful:

- http://ammehjelpen.no/handmelking?id=907 Short but clear video demo of a technique found to be effective (scroll down for English)

- http://www.kellymom.com/bf/concerns/mom/rev_pressure_soft_cotterman.html RPS, a technique found to trigger the let-down reflex at any stage of lactation

Please keep in touch and let us know how you get on.

xx

[loonar]

I do quite a bit of hand expression. It is without a doubt more effective than the pump, but a lot more time consuming. Right now I'm really trying to focus on getting as much actual nursing in as I can, even though it's awfully painful.

Honestly the blood is really disconcerting. I'm getting blood in my milk once or twice a week and it's not always associated with nipple damage. Last weekend there was so much blood it made my poor baby vomit. We are talking bright red milk, not just pink-tinged. 

My lactation consultant is stumped. She consulted several colleagues, and they were stumped too. She has referred me to a breast surgeon. 

My mom had breast cancer. I'm feeling terrified right now.

[Heba]

*Hugs* did the lactation consultant mention cancer?  If not, please please don't worry (I know, a million times easier said than done).  I can't imagine that your issues would be caused by cancer, but either way I'm glad you're on it. 

Thinking of you - please keep checking in!

xx

[elevena true]

pumping while typing one handed...

on blood in milk... you should look up "rusty pipe syndrom" which is a possible reason for blood in milk. i jusy know a friend who had it, not a lot about it myself.

hugs. hope things start looking up for you