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Thread: Nipple pain; almost exclusively pumping

  1. #1

    Default Nipple pain; almost exclusively pumping

    Help! My triplets were delivered by c-section 10 weeks ago. They were initially not quite strong enough to latch well, so I started pumping immediately. I had the help of a lactation consultant to teach me how and fit the equipment, but from the beginning it has been painful. My babies rarely get the opportunity to nurse but I would have loved for that to have been more the case. I think the pain has kept my milk supply very low and prevents me from pumping as frequently as I should. I've tried changing flange sizes, my industrial strength pump is on it's lowest setting and have consulted 2 lactation consultants who are completely baffled and have essentially given up on me. I was given Nystatin and used it for a day or two, but since my babies are almost never on the breast, have no symtoms and my breasts showed no improvement, I stopped using it. I am only able to produce enough to give my babies one supplement of breast milk a day and with the amount of pain, I'm beginning to wonder if such a small amount is even providing much protection for them. I have no cracks or blisters and use nipple cream or an olive oil based version consistently. I don't have deep breast pain, but deep nipple pain when first turning on the machine. I have to squeeze both breasts and bear through the pain for the first 2 minutes or so, then I can usually tolerate the pain level a little better. They are equally painful and are tender and achy after pumping. Because of some complications with my kidneys after delivery I had to stop taking ibuprofen, which helped some, and now can only use Tylenol, which helps very little. I'm completely at a loss and feel like I've tried everything. I mentioned it to my Dr. at my postpartum visit and she had no ideas to offer. I'm running out of options and the pain seems to just be getting worse. I don't want to quit because I know premature babies (& 3 babies in one house sharing germs) need all the extra immune help they can get! Any suggestions would be tremendously appreciated!

  2. #2
    Join Date
    May 2006
    Posts
    20,637

    Default Re: Nipple pain; almost exclusively pump

    Welcome and congratulations on the new babies! I'm sorry that nursing and pumping has been difficult and painful so far. You can have thrush, or the babies can have thrush, or you and the babies can all have thrush, without you needing to nurse much. Since you feel significant pain after pumping, thrush does seem like a possibility. Do you or the babies have a yeast infection anywhere? Vaginal yeast in you or oral yeast in the babies would certainly increase the odds that this is thrush.

    It's also possible that the issue is a poor-fitting breast shield on the pump. That can cause a lot of pain and potentially cause vasospasms (see http://www.kellymom.com/bf/concerns/...blanching.html). Maybe have a LC take a look at the pump and watch you use it? If there's a problem with fit it should become obvious fairly quickly.

    Your milk is definitely worth the effort you're putting in. I know it's super-challenging. My aunt had 35 week triplets by c-section about 26 years ago and she managed to breastfeed all of them- but I saw firsthand how much work that took! Nurse, pump, bottle-feed, nurse, pump, bottle-feed, repeat...
    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
    Join Date
    Mar 2006
    Posts
    10,440

    Default Re: Nipple pain; almost exclusively pump

    I suffered through major pain pumping for nine months. My initial thought is that the horns are the wrong size. I was sized by 2 IBCLCs, who both told me that I should use a 27, but it wasn't until I got a 36, used APNO and gave it some time(like months) that it stopped hurting. I am still sore, but not like it was.

    I also treated myself for thrush four times, and it did help after the fourth time (but I had clinical signs that time; the other three I didn't, but I didn't know what else to do).

    But what you describe is almost exactly how I felt about a year ago. It was hard.
    Susan
    Mama to my all-natural boys: Ian, 9-4-04, 11.5 lbs; Colton, 11-7-06, 9 lbs, in the water; Logan, 12-8-08, 9 lbs; Gavin, 1-18-11, 9 lbs; and an angel 1-15-06
    18+ months and for Gavin, born with an incomplete cleft lip and incomplete posterior cleft palate
    Sealed for time and eternity, 7-7-93
    Always babywearing, cosleeping and cloth diapering. Living with oppositional defiant disorder and ADHD. Ask me about cloth diapering and sewing your own diapers!

  4. #4
    Join Date
    Sep 2011
    Posts
    381

    Default Re: Nipple pain; almost exclusively pump

    I want to offer words of encouragement-any breastmilk is better than none. The previous posters had good advice. If you are able to comfortably pump, then by all means even 1 bottle a day is fantastic for your little ones. And fantastic for you too. You will find lots of support, assistance & encouragement in the forums. Welcome
    Full time working Mom to 3, DH is my hero as a SAHD:
    DS July'09, nursed for 12 weeks
    DD1 & DD2 April'11, tandem nursed for 16 months

  5. #5

    Default Re: Nipple pain; almost exclusively pump

    What kind of a pump is it and how old is it? Have you tried getting help troubleshooting from the pump manufacturer? I agree a likely cause is the breast flanges are not the right size, I believe there are also special flanges made by other companies that some moms find are more confortable. But I have also talked to moms using older pumps who had pain due to the motor running incorrectly. I guess this could happen with a malfunctioning newer pump as well. These were personal use pumps but I can see the same thing happening with a rental pump, assuming that is what you are using.

    Have you tried lubing up the flange with some olive oil and see if that helps at all? this is just a stop gap measure until you can get the right size.

    Maybe you just need a different pump. Of course when a mom is unable to nurse, the rental grade pumps are what are recommended. But occasionally a mom finds a less powerful pump, even a hand pump, works better for her. Hand expression is another option. These are not as likely to keep your supply where you want or increase supply, however, if it is too painful to pump anyway it really cannot hurt to try something different.

    Are the babies still hospitalized? Is that why they rarely get the chance to nurse? Are any of the babies able to latch? Is nursing painful? If you can nurse, at least some of the babies some of the time, that may be easier and more enjoyable for you than pumping. If you want to work on encouraging your babies to nurse, there is lots of info/help here and in many articles on llli.org and kellymom.com for that.

    If you have thrush, you are not likely to see improvement after only a couple of days of meds. The protocol is to take the medication for at least 2 weeks is my understanding. And Nystatin is the least effective prescription med for thrush. But I am not sure it is thrush at all. Pain is only one sign of thrush. The other most reliable signs are your nipples and/or areola have flaky or shiny skin. Have one of your LC's look up thrush for you in the lactation text Breastfeeding Answers Made Simple (Mohrbacher-2010) She has a very complete discussion of various nipple pain causes, many of which are mistaken for thrush, thrush, and meds for thrush.

    Some moms actually have a reaction to nipple creams. It's rare, but it happens. Especially since there is no visible injury I would suggest stopping all creams or oils for a few days and see what happens. Most Nipple creams, including purified lanolin, can only help speed healing when there is nipple damage. This is a great thing, but they don't actually solve any issues or prevent pain. The exception is All Purpose Nipple Ointment, which is a prescription compound, that has an anti-biotic and an anti-fungal and so appears to help prevent bacterial or fungal infection, but I am not sure about its effectiveness in curing these.

    Remember that pumping frequency is more imprtant that duration when trying to build supply. If it hurts to pump, try to pump more often but for a shorter amount of time if that helps. Don't worry so much about what you are producing, of course it is frustrating but it really is true that every drop of breastmilk is beneficial.

    Book suggestions: Mothering Multiples and Making More Milk

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