Healing cuts possibly caused by pump- help! (long)

[Sigur]

Sorry I am jumping right in without an intro, but I am desperate to get advice that I am on the right track hopefully.  I used to come to these forums back when my dd, now 7, was an infant, but forgot all my log in information so registered again.  I know you all give great advice so I thank you in advance.

I am a pretty experienced breastfeeder- I nursed my dc now 7 until she was 3.  So that is why it is especially frustrating to be having breastfeeding problems with my new dc, who is 5 1/2 weeks old.  My right side has always given me some problems historically- I had major scabbing on it during the first few weeks of my dc7's life, but it resolved once I got better latch.  I pumped only on that side while it was healing, for about a week, and then we were good to go.  

This time around, I was doing ok.  A few mornings when I was very full because my new dc had started to sleep through the night longer, I would only give dc one side and pump the other (the right side) to build up a freezer stash for a wedding in August.  Then, about a week and a half ago I started to have some pain at latch on with the right side.  Major, excruciating, burning pain that flared at latch and then disappeared.   When I inspected my nipple, I had a cut which looks like a slit right where the part of the nipple that sticks out meets the areola.  I started using lanolin again, and called a LC who advised that I try different positions.  I had been using cross-cradle, but started alternating with side lying and football, which caused less pain.  Two days ago, I noticed a second slit on the other side of the nipple, identical to the first.  I got so discouraged that I decided to exclusively pump this side until it healed, just like I had with my first child.  I never considered that these cuts may have been caused by the pump to begin with.

So all day yesterday I pumped that side.  it was not super painful, but it was not comfortable.  So at the end of the day I look at my nipple and I have two more cuts- it looks TERRIBLE and I am so sad and discouraged.  Like I just set myself back so much further, when I thought I was doing the right thing.  :(  So last night my dh went out and got hydrogels and a nipple shield.  I had the hydrogels on all night, although it is not a perfect science to get them to adhere to where the cuts are, because they are right in the fold of where the nipple meets the areola.  Things are looking a little better after last night, but the cuts are still there.  I had planned to possibly use the nipple shield to nurse the damaged side while still protecting the wounds.  

I think that my horns on my breast pump may be the wrong size and caused the damage.  I am taking advil for the pain 30 min before feeding.  I am letting BM get on it and air dry.  I plan to continue to try to use the hydrogels.  I offer the damaged side second to the baby.   The other side is fine, no pain, no damage, so I know her latch is good.  

So this morning, I grit my teeth and prepared for pain, and I nursed her on the bad side without the shield and it did not hurt at all!!!!!!!!  Football hold, advil before, hydrogels all might have been the cure- I don't know what did it but hopefully this keeps up. Wounds looked ok after nursing (as opposed to after pumping, when they looked bright red and open).

So how do I proceed from here?  I am so afraid of doing the wrong thing and causing even more damage, plus I don't want to lose my supply!!!!  I also don't know if there is anything else I should be doing.

Thanks so much for your input, and for reading this far!

[Viola]

My first thought is to stop using that pump, although trying new sized horns or flanges might work.  Can you get inserts to make it smaller, or is the issue that it is too big?  It sounds like the suction might be too strong also.  Maybe just concentrate on feeding at the breast and getting the latch good every time and letting the nipples heal before going back to pumping again.  But you could possibly pump on the left side and the pump might fit better there. 

[MichelleZB]

Are you leaving your baby for hours at a time? If not, forget about pumping and just nurse exclusively, at least for awhile.

If you need to save up milk for that wedding in August, I recommend good ol' fashioned hand expressing!

[HappyHappyMommy]

I exclusively pumped (I know that's not your situation), but I struggled in the beginning with cuts and cracks near my nipples. Mine were caused by a combination of the following: ezcema (never had it before on any area of my body), thursh (aka yeast infection), and issues with the pump flange sizes, suction, and the pump. I ended up seeing a Lactation Consultant who was experienced with pumping and she helped me figure out the right flange size (I have larger than average breasts so I figured that I needed larger flanges--wrong!) and immediately the pain reduced significantly. Then she helped me with the suction and helped me understand that one of my pumps had suction strength and suction speed on different dials and helped understand how to get a combination that produced lots of milk; it also reduced the pain. (By the way, my other pump, which did not have suction strength and suction speed on different dials was much harder to comfortably pump with, so if you can, you might try renting a different pump and see if that helps.) I then went to see my gyn who helped me with the ezcema and thrush.

Wishing you quick healing on your cuts and no pain going forward!
 

[gemasita]

Good advice here.  I was going to second the hand expression idea until you get the pump figured out.  It's a great skill to have and doesn't hurt or damage your nipples!!!