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Thread: Really struggling with lots of pain (sorry long)

  1. #1
    Join Date
    May 2011
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    Default Really struggling with lots of pain (sorry long)

    Hello, I am new to these forums and I am hoping that someone might be able to help me or at least reassure me that things will get better. I have been EBF my 4 week old little girl and have been having problems since then.
    Our breastfeeding relationship started off a little rocky as she wouldn't initially latch and I was advised to use a nipple shield for the first 36 hours which I now believe to have been bad advice. She then latched on and was getting good amounts of milk once my milk came in and gaining appropriately but I have persistently had pain during nursing, often to the point of tears. My nipple usually comes out of her mouth with a dramatic crease in it, particularly on the right side. The left looks more like a tube of new lipstick and I have large cracks/sores on both nipples, worse on the right.
    I have seen several LC's both in the hospital before discharge as well as since then along with being seen by a breastfeeding medicine specialist. We have worked on latch issues and it "looks" OK as far as anyone can tell. She seems to get a decent bite of areola and was getting milk ok and gaining weight appropriately. We have worked to try and adjust the latch anyways just to make sure it's as good as we can get. In spite of all this my nipples are destroyed and got to the point where I pumped exclusively for a few days and gave her milk in a bottle which I hesitated to do but was done on the advice of the breastfeeding medicine doc. She told me to go back to a nipple shield until I was healed and then go back to the breast. I am super hesitant to use the shield and not sure it really feels that much better anyways.

    I put her back to the breast today and they have healed a bit so it feels a little better but the nipples are still coming out abnormally shaped. To make matters worse, she seems to be having a more trouble getting milk out than she used to and doesn't always seem to be satisfied. I worry that the bottlefeeding has irreparably hindered breastfeeding.

    I am using APNO cream ( for about 36 hours now), and really working on getting a good latch but my nipples are still coming out of her mouth odd shaped. The consensus that I have gotten is that her mouth is just not big enough and she is having difficulty getting a deep latch as well as moving her tongue a bit abnormally and that I just have to give it some time but nobody knows exactly how much. Baby was full-term and was 7lb6oz at delivery and at last check was over 8 pounds ( about a week and a half ago),

    My question is whether or not I simply have to endure toe-curling pain for the next several weeks while she nurses until her mouth gets bigger or is there something else I can do. I desperately want to BF and my goal s at leas a year but I can't live in this kind of pain. Add in what I suspect is a mild case of PPD and I am at my wits end. Any help would be appreciated.

    Thank you

    Kristen

  2. #2
    Join Date
    May 2006
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    21,244

    Default Re: Really struggling with lots of pain (sorry long)

    Oh Mama... 5 years ago I could have written your post, nearly word for word. I had the creased, lipstick-shaped nipples, the gigantic cracks, and the toe-curling pain. And probably PPD as well, though that's a retrospective diagnosis.

    Will you need to endure this awful pain for weeks and weeks? Perhaps. I want to tell you that "everything gets better at 6 weeks" as so many people told me, but that isn't true for everyone. For me it took 4.5 months for my baby to grow big enough to latch on well, and for my nipples to heal up. Here is what helped me during those difficult months:
    - See a lactation consultant, preferably an IBCLC. Nothing beats hands-on help, and maybe the IBCLC can help you troubleshoot the latch.
    - Rent a professional scale and do some weigh-feed-weigh tests on the baby to determine milk intake. When a baby has a marginal latch, milk transfer can be reduced, resulting in lowered supply. This can be a particular problem when using a shield, since shields can also reduce or slow milk transfer.
    - experiment with different nursing positions. Many moms have success with the football hold. I personally had the most luck with the side-lying position, since that allowed me to use both hands to assist the baby with her latch, since I didn't have to hold the breast.
    - keep the humidity in your house high. My cracks didn't heal until a steamy July with no air conditioning.
    - Use a combination of 1% hydrocortisone cream and Bacitracin antibiotic ointment on your cracks to combat inflammation and infection. Mix and apply using a clean finger, and use a pea-sized amount.
    - Hydrate the cracks before nursing by immersing your nipple in a shot glass full of warm water, or by soaking them with a sopping wet washcloth. Moist scabs tear open less painfully than dry ones.
    - google the "nipple sandwich" technique and try it out. It can really help you cram the maximum amount of breast into a tiny mouth.
    - give it time. I know that what you're dealing with is agonizing, but eventually it will end. I thought I'd be nursing on cracks for a whole year, but eventually they healed leaving no scars. I nursed my first LO for 3 years, and I know that things can get better even if you start at the absolute lowest low point.

    Let us know what we can do to help! My heart totally goes out to you and your baby.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  3. #3
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    Default Re: Really struggling with lots of pain (sorry long)

    I have been there!!!! SO many of us have!!!! I can assure that YES it will get better...I don't know when but it will! Its great that you have the APNO as it will help deter infection and thrush while you are healing and have open wounds. Make sure that each time you nurse you are letting your nipples air dry before covering them up again. Also to deal with the pain while you are healing and baby is growing into a better latch you can take Ibuprofen. I will be honest and tell you that I took it every day throughout the day for about 5 weeks and it did take the edge off enough for me. You can also try numbing your nipple with an ice cube right before baby latches on. I had one nipple that came out with a crease every time and honestly, even now that I have a good latch and am nursing smoothly, it still does. I know some may disagree but I do think (after 4 kiddos) that sometimes, for some people, the baby does just have to grow enough for her mouth to be big enough. I have large nipples that are short and it was just not compatible with a 6 pound newborn's mouth. Now, my 8 pound baby has done much better but I did have some pain and damage initially that has now, at 8 weeks completely gone away and the damage has healed. SO, it is more than possible!!! I hope some others might have some great tips to help with some of the other things you are dealing with.
    Mama bean to E-bean (7), A-bean (4), C-bean (16 months) and baby bean (3-28-11). We are successfully for the first time!!!

  4. #4
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    Default Re: Really struggling with lots of pain (sorry long)

    Thank you for the replies. I have seen a IBCLC and have worked on latch and she believes that the latch looks good and that it is something she is doing with her tongue on the inside and is at a loss as to how to help me. Maybe I need to find another on (she is the 3rd I have seen).
    I have never tried the side lying positions. Do you know of any videos that demonstrate how this works. I always have to hold my breast during nursing since I have pretty big breasts (G/H cup at the moment). I have tried both cross-cradle and football and either one seems to give me the same results. I will try immersing my nipple in water/saline and see if that helps the pain when she latches on.
    I have read a little about moist wound healing and putting saran wrap over the lanolin/ointments underneath breast pads or bra in the womanly art of breastfeeding. Has anyone done this? does it help? It would seem to me that keeping things that moist without air circulation would create a breeding ground for infection/yeast.
    Any idea where to rent a scale to measure pre/post-feed weights? I would love to be able to do this as I have no idea how much she is getting.
    I have been taking ibuprofen religiously in part for c-section pain that is just now getting better. It does seem to help with the pain but oh boy do I notice when it is wearing off, especially the first feeding of the day.
    4littlebeans-I think I have the same situation in that I have large nipples that are on the shorter side, not exactly flat but not out all the way either. Although my little one is over 8 pounds not, she is long and lean and has a pretty petite mouth.
    An additional frustration is that my hubby gets really frustrated at the situation and would rather I just give a bottle/binky. We introduced a binky 2 weeks ago on the advice of the IBCLC because she said it would help her learn to suck. I haven't read anything that correlates with this advice and wonder if that was a mistake and if I should take it away. She doesn't love it but sometimes it seems to help when she has eaten well and just wants to suck and it hurts to have her comfort suck on me.

    Thanks again for all the advice. I never thought this would be this difficult and hope and pray that by enduring a few more weeks of pain that we will end up successfully breastfeeding for at least a year which is my goal.

    THanks

    Kristen

  5. #5
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    Default Re: Really struggling with lots of pain (sorry long)

    I would definitely seek out another LC. You never know- fresh eyes sometimes pick up on something that has been missed. I saw 2 LCs and each had slightly different approaches. At the very least, the LC should be able to help you try out the side-lying position. (Wish I had a vid, but I don't.). And the LC should be able to rent you a scale, or at least direct you to someone who can.

    Nursing when well-endowed can be tricky. The breast is heavy and can drag down on the baby's mouth, which can cause her to slip off the breast and suck juston the nipple- ouch! Try to keep the breast supported throughout the feeding when nursing, either by holding it with your hand or propping it up with a rolled up washcloth. Mastering the side-lying position can help because the bed does all the work of supporting the breast.

    Moist healing can provide a breeding ground for yeast or infection. But if you don't have any symptoms of yeast or infection, you probably don't need to worry about that right now. Cross that bridge when and if you come to it.
    Coolest thing my big girl said recently: "How can you tell the world is moving when you are standing on it?"
    Coolest thing my little girl sang recently: "I love dat one-two pupples!"

  6. #6
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    May 2011
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    Default Re: Really struggling with lots of pain (sorry long)

    I would also add that I highly highly recommend getting some of the Medela soft shells for sore nipples. These have bend a saving grace for me as I've healed. They allow for moist wound healing and air circulation at the same time while keeping raw tissue from sticking to your bra. The hydrogel pads are also nice to use as well as they are breathable (according to the company) but also support moist wound healing. I've not heard of using plastic wrap to be honest. Also, here is a good link about healing damaged nipples: http://www.kellymom.com/bf/concerns/...lehealing.html
    Mama bean to E-bean (7), A-bean (4), C-bean (16 months) and baby bean (3-28-11). We are successfully for the first time!!!

  7. #7
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    Default Re: Really struggling with lots of pain (sorry long)

    Hi there!

    Sounds like you are doing a great job despite the pain. You should be proud of yourself!

    I just wanted to tell you that nursing while lying down is great once you feel comfortable. I first did it out of desperation when I was exhausted with my older son. It was AWESOME. I used to put something under my breast, such as a washcloth like PP said. You can use anything that works for your size and comfort. I actually have found that depending on how my breast is laying it may not be necessary. as my lo has gotten bigger its been even easier.

    Definitely try it!

    Good luck with the soreness mama!

  8. #8
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    Default Re: Really struggling with lots of pain (sorry long)

    Thank you again. I have contacted another LC and will hopefully be speaking with her today. Overnight I still seemed to have some difficulties with pain but can't seem to figure out what if anything I am doing wrong with the latch. So frustrating. I think part of the problem may be getting my LO to open her mouth wide enough. She is so anxious for food that she is already trying to suck before I even get to her. Trying to catch a wide open gaping mouth is somewhat challenging. Add in a little bit of an overactive letdown and we are both a mess. When I sandwich my boob half the time I end up spraying her or at least getting milk everywhere!!

    fourlittlebeans-I actually bought the breast shells but after only having them on for a few minutes my entire shirt was drenched, even with the little foam inserts in them. I think the pressure just makes my boobs leak too much. I had a pair of the hydrogel pads and they felt pretty good but the package said I needed to wash my nipples before every feeding while I used them and that was simply too painful so I quit using them. I do wonder if I may have a low-grade thrush infections that could be contributing to all of this but my LO doesn't show any evidence of it. I was on antibiotics for a week post delivery for a suspected incision infection so who knows. Nobody else seems to think so but I wonder.
    Last edited by @llli*buckeyebaby2011; May 27th, 2011 at 08:00 AM.

  9. #9
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    Jan 2008
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    Default Re: Really struggling with lots of pain (sorry long)

    I went through what you are going through just a few months ago, and also when my DD was born 3 1/2 years ago. It's horrible. But I went on to nurse DD for 18 months and am now pain-free nursing DS, who is 4 months. I think we really turned the corner at 7 weeks or so. I also used ibuprofen throughout the day to keep the pain bearable and, although they leaked like you mentioned, I used the breast shells to keep my bras off my chest. I just stuck the shell in the bra and put a nursing pad over it. You can also fold a nursing pad in half and put it inside the shell, since the foam pieces are not very absorbent.

    Our latch was fine too. I obsessed about it and saw the LC several times but it came down to this: I have very sensitive skin. I have flat nipples. DS had a small mouth as all newborns do and a very strong suck. All of these combined made for giant wounds and I thought my nipples would never heal. But they did! It just took a little more time than I would have liked.

    Good luck with your appointment; let us know how it goes. The things I would ask her/him to look out for are: symptoms of thrush, or tongue-tie. Also, do your nipples change color at all after feedings? For example, I have vasospasms so mine turn white soon after feeding or when exposed to cold air. This made them burn and increased the amount of time until I was pain-free. (They still change color but the burning isn't even noticeable anymore.)
    Karen

    Proud mama to
    Kaitlyn Ann 12/23/07 - 7 lbs., 15 oz.
    11/09
    Jackson Thomas 1/16/11 - 9 lbs., 3 oz.


  10. #10
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    May 2011
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    Default Re: Really struggling with lots of pain (sorry long)

    kaitlynsmom-Thank you for sharing your experience and words of encouragement. It definitely sounds like our issues are similar. We have ruled out a tongue tie and they tell me it's not thrush although I still wonder a little bit if it could be low-grade. Hopefully the miconazole in the APNO will help with that if that is in fact the case. I wish I could use the shell though. I actually soaked through a nursing pad that was over the shell quickly. I think the nursing bras I have are a little small which may be part of the problem as I got bigger than I thought I would. I need to go to Nordstrom's and get fitted for some bras soon since I am an uncommon size (34 G/H). I don't think it's Raynauds at this point since my nipples don't seem to turn white after a feeding but apparently I am at higher risk for that due to a h/o autoimmune disease.

    Thank you
    Kristen

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