Is this thrush or something worse? UPDATE: Severe nipple trauma-help?

[JFTB1177]

So I am still BFing my 15-month-old but only at night. If you've read my other thread (lol) you know he HAS to nurse alllll night long. A few days ago I noticed when he latches it HURTS! Something that hasn't happened since he was a newborn.

I thought it was just his teeth until I looked today and saw my right nipple (the one that hurts) is all inflamed, pink and raw looking. My other one is fine. My first thought was maybe it was an infection. Then I thought thrush, because DS just got over a double ear infection and has been on antibiotics for 10 days, plus DS's rear end looks "splotchy", not a full-on rash but like the beginnings of something. I don't see anything in his mouth though.

I started Googling this morning and freaked myself out by reading about something called Pagets that is a rare form of breast cancer on the nipple. I have OCD and haven't had an attack like this is a while but I scared myself so bad I got diarrhea. I know logically it is unlikely but I always think worst case scenerio.

I went to the ER this morning and dragged my poor little guy so they could use him to dx me (check his diaper area, mouth etc). The doc barely looked in his mouth (didn't use a tongue depressor or anything) and refused to look at his diaper area to see if it was thrush. In fact she said if it is thrush it "would be in the mouth, not his behind"...?? I showed her my nipple and she said it could be the beginnings of a candida infection and wrote me a rx for nystatin. I asked her if it could be anything worse and she said well if it doesn't go away I might need antibiotics. Thanks doc

What do you think? Can I get thrush when he's only nursing at night and is a toddler?? I am worrying myself sick here that it could be something else. My gut says it's thrush but my mind keeps saying "but what IF, what IF!!!!"

Edited by JFTB1177 - 5/29/12 at 4:56am

[JFTB1177]

Ok I feel like a total idiot but I *think* I may have figured it out! I fell asleep next to DS2 after getting home and when I woke up my nipple was hurting and saw that my bra had "caught" right under my nipple, where it is swollen and irritated. Then I thought about it and realized that's where my bra ALWAYS "catches", every single day (I think I need a new bra!). I just looked and the crease of my nipple right where the bra catches has split open, like a large crack. So maybe this is it? I don't even think it's thrush anymore. I took off my bra and won't wear it anymore and see what happens!

[JFTB1177]

Ok I know I sound mental but I'm back to thinking it might be thrush. I didn't let DS nurse on the right side at all last night but this morning the right side was leaking and breast was engorged and uncomfortable so I let him nurse. Didn't hurt this time. But noticed afterwards nipple was dry and flaky looking, with peeling skin. It's just on the right side. Idk what to think anymore but I'm back to being scared...hope some experts can weigh in!!

Thanks!!

[motherhendoula]

I had a bra that 'rubbed' against my nipples so badly that i thought it was thrush too, friends at LLL even agreed with me - although baby had NO symptoms.  I went to the dermatologist who told me it wasnt thrush, just basically abraded and irritated skin - she said she would use hydrocortisone if i wasnt nursing -  Hydrocortisone is actually not bad for babies - i wasnt in such bad shape that i had to use it often - i think i used it twice and of course...stopped wearing that bra! 

i was better in a few days - but my nipples were as you described - pink, flaky, a bit sore.  If babe has no symptoms and you are feeling OK - just stop wearing that bra and see if clears on its own - if not, you have the Nystatin

Get off the internet and stop freaking yourself out!

[JFTB1177]

Thanks for replying, motherhendoula!! Was your irritation only on one side of your nipple? Mine is just on the underside, although it is a tiny bit flaky on the top as well. The red/pink puffiness is only on the underside and it has spread a tiny bit onto the areola. And also, I only have 1 nipple affected- that's what also has me worried.

The affected area is shiny, pink, has that peeling, white-ish skin. I had stabbing pains when DS nursed for a few days in a row, but no stabbing pains this morning. I want to go to the OBGyn to get checked out but I have no health insurance right now (in the process of getting it back).

ETA: One more thing, I don't know if this means anything but my right breast was leaking allllll night long since I wasn't nursing from that side...do you think that has anything to do with the peeling?

[PatioGardener]

I'm nursing a 2 year old. About 6 months ago I had a sore nipple - it was a combo of a lazy toddler latch (now we always have a BIIIIG mouth and I pull in tight to latch) and thrush. I used monistat cream twice a day for a few days and the crack cleared right up. Interestingly it was both sore and kinda itchy at the same time. My 'home remedy' for my sore nipples is 1) check for a milk blister and deal with it if that is the issue, 2) correct latch 3) try some monistat if nothing else works and 4) wash well in the shower. My nipples can get overwhelmed by baby sweat and saliva, so keeping things well washed decreased irritation. So far it's worked every time.
 

[JFTB1177]

Hi Patiogardener!! What did your sore nipple look like, can you describe it? I mean was it like mine? Thanks!

[JFTB1177]

I found something on Pagets disease in this scientific article http://dermatologycentral.typepad.com/files/nipple-and-areolar-eczema-i.pdf, at the top of page 3 it says it would be a rare event in a breastfeeding mother and has not been reported in literature.... do you think I can rule this out then, for the most part? It also says the average age is 50 (although I know many women get breast cancer in their 20s and 30s).

I keep checking it all day and it's starting to look like it's slowly clearing up....we'll see!

[PatioGardener]

My line of thinking goes: thrush = common; cancer = rare. It makes sense for it to be the most common thing. If it doesn't clear up, then I start to worry, but not before, as experience has taught me that it's not worth the energy to worry right away.

I think it is great news that it is clearing up! Hope you are feeling better (and also less worried) soon.
 

[PatioGardener]

Originally Posted by JFTB1177 

Hi Patiogardener!! What did your sore nipple look like, can you describe it? I mean was it like mine? Thanks!

It has a crack (cracks are common with thrush) and was pinker than normal. Also it was only on one side.

[JFTB1177]

Thanks Patiogardener!! I wish I could post a pic but don't wanna be flagged for pornography.

The crack has gone away, I've been using lansiloh since yesterday. No more dryness but pink, inflamed area still there. Doesn't itch or hurt. No discharge or anything. I decided not to use the nystatin b/c I'm not convinced it is thrush and I won't be able to nurse from that side if I use it (they didn't prescribe me the oral nystatin but the cream which baby can't ingest). I'm thinking (hoping) it's just contact dermatis (sp?) that made the crack, then maybe it got yeast inside or something and that's why it is inflamed? Idk... DS shows no signs of thrush though and seems totally fine. Man I wish I could get in to see a doc to give me peace of mind!

[JFTB1177]

Just wanted to update that I've been having minor shooting pains in my rt breast/nipple. Last night it looked better but this morning it looked back to how it was. Now it is 2:30pm and it looks like it's getting better again...I only nurse at night, do you think this is why?

ETA: I also just had some shooting pains in my left as well... weird! I just started AF today, maybe that's why??

Edited by JFTB1177 - 5/24/12 at 11:48am

[PatioGardener]

Check out Dr Jack Newman's thrush protocol - you may see something there you'd like to try.

http://www.breastfeedinginc.ca/content.php?pagename=doc-CP
 

[Mulvah]

Sounds like thrush to me, something I have too much experience with.   I would make homemade APNO - mix equal parts 1% hydrocortisone, polysporin, & lotrimin/monistat/miconazole ointment. I would put that on after every nursing session.  I would also sometimes put acidophilus powder on top of the APNO and then cover my nipple/breast with a breast pad under my bra.  I would give my little one some probiotics, too. 

I have also followed Dr. Jay Gordon's thrush treatment with grapefruit seed extract and that has helped, too.  I used that when my LO had thrush (mouth) and it worked pretty quickly.  I won't touch Gentian Violet, but that's just me. 

[JFTB1177]

Originally Posted by Mulvah 

Sounds like thrush to me, something I have too much experience with.  

Thanks ladies!! Do you think it could be thrush even though it's only on one nipple and I have no pain or itching, and I've only had the shooting pains once or twice?

[JFTB1177]

I know ya'll are sick of hearing about this already (lol), but... so it looks like it's healing BUT there is still that white crust on the affected area. I tried to pull off some (pinpoint size) and it left a red raw area. What the heck is going on?? It's not oozing or bleeding or anything, and no nipple discharge at all (sorry TMI).

I may be getting health insurance in the next few weeks so will hopefully be able to go to the doc and leave you guys the heck alone lol!

[JFTB1177]

So I think continuing to nurse on my rt nipple has made it a ton worse... what started out as a "simple" crack in a nipple is now 3 huge, deep, cracks (on the side and base) that are raw and open after nursing and crust over in the hours after. My nipple looks horrible and I feel if I had let it "rest" it could heal but if I do I know my milk will dry up for good since I am only nursing a few times at night now (babe is 15 months). :( Like I said before I did lansiloh when it was just one crack and it didn't heal it. I think all the crusting over, then un-crusting (when nursing- I know, GROSS!), then crusting, etc caused those other cracks. What do I do? Can't pump- my body does not react well to a pump and it will be the same as quitting. Should I just keep nursing until my annual exam at the end of June (I DO have health coverage just for that visit!) and then see what the doc wants me to do then? Also, I know it's traumatized again b/c it HURTS BAD to nurse on it again. :(((

[alittlesandy]

Can you get someone to prescribe APNO? I had horrible problems nursing my son because of nipple pain and deep, bloody cracks. This stuff saved my life:

http://www.nbci.ca/index.php?option=com_content&view=article&id=76:all-purpose-nipple-ointment-apno&catid=5:information&Itemid=17

[PatioGardener]

What have you tried to treat it?
 

[JFTB1177]

Thanks, alittlesandy, I will check that out!

Patiogardener- I haven't really done anything yet since I haven't been able to go to the doc and don't know what it is (yeast, bacterial, just damaged skin, something else, etc). I just keep nursing as normal. I looked at it after DS nursed tonight before I put him down for bed and the cracks/splits/gashes or whatever they are are now extending all the way around the nipple!! It's like it's getting worse, not better. And it hurts bad when he latches but stops hurting after 30 sec or so. What should I do?? Should I go back to the ER or just wait a couple of weeks for my health insurance to kick in??