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Thread: Vasospasm from nipple trauma

  1. #11

    Default Re: Vasospasm from nipple trauma

    Thank you all for your help. It really means a lot.

    I bought the pump new in July, and I was using it once nightly in the first month or so without any problems. I had sore nipples since the very first day and got plugged ducts every so often, but that didn't really bother me. Other than that, everything was going well.

    We went on vacation for two weeks in November, so I started pumping more. I also noticed that my nipples would be more sore than normal after nursing, but I figured it was because of the unfamiliar environment. I also went back to work on Dec 1. The pain started when we got back after Thanksgiving, and it was a shooting pain that occurred only after nursing. It would start at the nipple and move outward, stop for a few seconds, then start again. They would last quite a while but would go away once I started nursing/pumping again. They didn't happen after every feeding. At first, it was only after I breastfed, then about a month ago I started getting the pain after pumping as well. I noticed that I usually got the pain when baby didn't completely empty me out. I would try to pump immediately after, but by then it was too late and the pain was there.

    I suspected thrush, so I went to the doctor. My doctors (GP, OB, and an Urgent Care doc) weren't convinced that it was yeast and told me to try aggressively massaging, because they thought it was probably just plugged ducts or something. I convinced my GP to prescribe me Nystatin, but she was reluctant to prescribe anything else. I used that and got baby on it as well. I asked my OB to prescribe Dr. Newman's APNO, but he said I just needed to use Lansinoh lanolin, but that was what I was using and read that wasn't good for thrush. I tried clotrimazole and taking GSE and acidophilus, but nothing really happened and the pain continued. I was about to try gentian violet, but before I did, I wanted to see someone else and get their opinion.

    I went to an IBCLC who said I might have Raynaud's because she noticed blanching on my nipple and said vasospasms mimic thrush symptoms. She had me try some Chinese herbs, but those didn't work. So, she said to keep warm and take vitamin B and calcium. That helped a little bit along with using a hot water bottle before and after the feed, and I thought it was pretty much under control for about a week and a half. I was still having pain, but it was more bearable than it had been, but now they're bad again.

    This pain has consumed me, and I feel bad for my husband and baby. All they hear about is how much my boobs hurt. I find myself Googling my life away. I'm ready to try anything at this point. I asked my doctor if she would prescribe me nifedipine as an LC at the hospital I gave birth at suggested. I might go ahead with gentian violet too if that doesn't help. I'm just exhausted.

  2. #12

    Default Re: Vasospasm from nipple trauma

    Jeepers, you have been through it. I strongly urge you to see the same or another IBCLC, maybe one connected to or with some influence on a doctor who can write prescriptions, and explain you are still having these difficulites. Nursing and pumping should NOT hurt like this, something is clearly up. This could be thrush, it could be a bacterial infection of the nipples., it could be vasospasm as well but frankly it sounds like more than vasospasm is going on. bacterial infection of the nipples could be ruled out by having a culture done and would be treated by antibiotoics. A bacterial infection of the nipples is NOT classic mastitis that causes flu symptoms or a fever, btw, I assume that has been ruled out.

    APNO is a good idea as a preventative but if you have full blown thrush or a bacterial infection you will likely need oral meds to take care of it. (Although, some moms find gentian violet effective.) If is is thrush, you may want to have your pump entirely disinfected, right down to the filter, if you can, and then be very careful about washing pump parts.
    The breastfeeding text Breastfeeding Answers Made Simple (Mohrbacher, 2010) has a very complete discussion of thrush and other causes of severe nipple pain including suggested medications and dosages. Your IBCLC should have this book.

  3. #13

    Default Re: Vasospasm from nipple trauma

    Thank you! I have an appointment with my doctor in a couple of weeks (wish it were sooner) to see if I can get a culture done and/or a prescription for nifedipine.

    I spoke to a couple of lactation educators when I went to buy some pump parts this morning, and they recommended I try bacitricin/polysporin if I think it's bacteria. Should I try it or wait until after my dr appt?

  4. #14

    Default Re: Vasospasm from nipple trauma

    Why you have to wait two weeks to see a doctor? Is this because they won't see you before then or, due to costs, you cannot afford an appointment before then?

    Not being able to nurse due to terrible pain is potentially a serious health issue for both you and your baby which can lead to premature cessation of breastfeeding. Plus I am concerned about any untreated infection, should that be present. I really wish you could see someone sooner, but I understand you have already seen lots of folks with little result, which of course is so frustrating.

    The problem remains that you want to see the RIGHT someone-a person who is familiar with unusual breastfeeding issues and willing to do what is necessary for proper treatment. And finding such a person can be hard. Again, I would start with an IBCLC but before paying her anything ,give her your history and ask her if she thinks she can help you and if she may be able to recommend you to a doctor who can write prescriptions and who is willing to prescribe what is necessary for proper treatment should it turn out prescription meds are warranted.

    According to Breastfeeding Answers Made Simple, a course of oral anti-biotics has ben shown to be more effective in treating confirmed bacterial infections. A topical anti-biotic is probably fine to try, but it may not solve the problem. (I am just repeating what is in this breastfeeding text that any professional Lactation Consultant should have, so I am not trying to suggest this is what you need to do.)

    I don't know where you live but in the US, CLE (Certified Lactation educators) are not required to have the same educational or clinical hours that a IBCLC does. It's a different specialty. Of course, I have neither the training of a CLE or an IBCLC, I am just repeating what is in BAMS, and there is much more in there about difficult to resolve nipple pain and the possible causes, I really wish you could find someone who has this resource to walk you through the various possibilities.

  5. #15
    Join Date
    Mar 2006
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    10,440

    Default Re: Vasospasm from nipple trauma

    I would suggest renting a hospital grade pump.

    I was super duper sore until I quit using any professional grade pumps and just used a hospital grade pump. I didn't do that until my baby was like 9-10 months old and it took another month for the soreness to abate. But the suction is different. And for some moms, the suction makes a big difference.

    It took time for the soreness to go away. So it is probably not an overnight fix. But it might help.
    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!

  6. #16

    Default Re: Vasospasm from nipple trauma

    The earliest appointment my GP had is in two weeks. I left her a message to see if i can get in earlier, so we'll see. This is another GP since i have two that are sharing patients, so maybe she'll be more willing to write me a prescription. When I went to Urgent Care, its a crapshoot what kind of doctor is on duty, and I got a doctor who obviously had no knowledge of breast feeding at all.

    A couple of weeks ago, I called to make an appointment with an IBCLC at the hospital and told her all my symptoms, and she helped me over the phone. She told me that she didn't know if I should come in because she would've probably just told me the same thing she told me on the phone and she didnt want to have to charge me. She said to just tell my doctor that I spoke to them and that she told me to get on nipedifine. I did that, and my doctor told me to make an appointment to see her.

    I was thinking of renting a pump from the hospital boutique. I'm out of town right now, but I'll definitely look into it when we get back. Thank you!

  7. #17

    Default Re: Vasospasm from nipple trauma

    I got bumped up to an appointment with my doctor today, and sadly, she wasn't any help. She said the good news is that there are no signs of any kind of infection: no thrush, mastitis or bacterial infection on the nipples. The bad news is that she doesn't have a solution for my pain. She said that women with fibrocystic breasts, which apparently I have, tend to be more susceptible to pain. It's possible that this affects the circulation during let down and feeding. She was just about to prescribe me a low dose of nifedipine, but she realized that I already have low blood pressure, so it wouldn't be a good idea for me to take it. She said that at this point I'm going to have to decide if I want to wean or continue nursing with the pain. I wanted to cry. I'm a little depressed, but I guess I've done pretty well for 8 months.

  8. #18
    Join Date
    Mar 2006
    Posts
    10,440

    Default Re: Vasospasm from nipple trauma

    I have fibrocystic breasts as well.

    Is the pain just at pumping? If so, and a hospital grade pump doesn't help, you could supplement during work and nurse at home.
    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!

  9. #19

    Default Re: Vasospasm from nipple trauma

    I am in the exact same position, its kinda freaky how similar our situations are. My son is 2 1/2 months old and we have been through hell and back with nursing. So much money has been spent on LC to then only find out that he was tongue tied, he is still lip tied, has a high palate like me, a strong gag reflex and a bit of a over bite. So you can imaging how nursing has been. Im on day 3 of solely pumping and have ran into the breast shield problem too. Just went out and bought 21cm cause my left areola is smaller then my right so I use a 24 for the right. It still hurts like a b*tch tho. I was getting the vasospams when nursing but its gotten ten time worse since pumping. I don't want to go to formula, Ive tried everything to help my little guy nurse but pumping it is and thats as maddening. Do to the nursing not going so well with his bad latch and poor suckle, my mild started to drop so by the end of the day Im low on supply. Taking the supplements to help increase. I thought nursing was going to be a breeze!! We should talk more and vent together and help each other.



    Quote Originally Posted by @llli*kriskross View Post
    Thank you for your suggestions and support.

    I've been using the 21mm flanges lubing them with coconut oil and pumping only 10 minutes at a time, and it seems to be getting slightly better. I had minimal pain for a couple of weeks, but sadly, the vasospasms came back at full force this past weekend. They're also now on the left side as well. I'm ready to give up and just formula feed. I really don't want to, but it's been such a struggle the past 3 months trying to figure out what's going on.

    I've spent so much time, energy, and money, and now, I feel so stressed out and hopeless. I went through phases where I thought it was thrush and tried to fix it with home remedies and Nystatin. Didn't really help. I was told it was Raynaud's, but applying heat and wearing a bunch of layers hasn't worked. Airing out the girls actually helps, but I can't really have them hanging out all the time especially at work. I've been taking vitamin B and calcium supplements, but I'm not sure how affective that is. I've been trying to change positions to try to get a better latch, but baby doesn't seem to be enjoying any of them and refuses to nurse.

    Sorry to vent, but I'm just a mess. Thank you all for being so kind on this forum. It's nice to know that there are so many mommies out there that care and are willing help.

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