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Thread: Sever breast & nipple pain - no help from Doctor

  1. #1

    Default Sever breast & nipple pain - no help from Doctor

    I'm breastfeeding my 3rd child... you'd think I'd have this all figured out by now & would be the one ANSWERING questions, alas....
    I had my son 3 weeks early and he's now a month old. We've been breastfeeding since birth, but I've had constant pain since we started. It's mostly my right breast, but they both hurt - breast & nipple. A couple times I've had blood in my milk from my right breast & I can't tell if it's coming from my nipple or if it's in the milk. I have a crack in that nipple that's slowly but surely healing. My breasts feel deeply bruised. I have been pumping to try & up my supply & might have been pumping too aggressively, but for at least a week I have only turned the pump up high enough to get a stream of milk to come out. In my right breast, I only get milk out of one pore - just only lonely stream of milk. I have seen the LC at my Pediatrician's office several times now - she says baby's latch is "text book" perfect. Yet when he comes off the breast, my nipple is pinched like a tube of lipstick. This is all very frustrating. Additionally, I started the mini pill just over a week ago, and I started my period 3 days ago. It's VERY heavy, which is unusual for me, and I'm having very painful cramps.
    Like I said, I've seen a LC 3x and my OB looking for help. They say "I'm doing great" and "just to stick to it" despite all of the above facts. I'm about ready to give up. With two other little ones to care for this has been overwhelming. Any advice would be greatly appreciated.

  2. #2

    Default Re: Sever breast & nipple pain - no help from Doctor

    UGH - Severe, not sever. TY sleep deprevatation.

  3. #3
    Join Date
    May 2006
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    20,852

    Default Re: Sever breast & nipple pain - no help from Doctor

    Welcome to the forum and congratulations on the new baby! And congratulations on toughing it out with breastfeeding despite the crack and the severe pain. BTDT, and I know that you're not kidding about how much it hurts. There were days where I would rather have stuck my finger in an electrical socket than nursed my baby on cracked nips.

    Based on what you're describing, I am thinking 2 things. First, I think that despite the latch looking textbook on the outside, it's still poor on the inside. That's really typical, and I hate it when LCs just shrug and say "it looks good!". Lipstick nipple + crack = latch issue. The good news is that the crack is healing. Once it heals completely, the pain should be much reduced. Usually time takes care of latch issues, if you can just be tough enough and patient enough for the baby's mouth to grow. Until then, here are some things you can do to cope:
    - start nursing sessions on the uninjured side- babies often suck most strongly at the beginning of a feeding
    - moist healing- keep the humidity up in the house, use lanolin ointment on the crack, try gel pads
    - hydrate the crack before nursing by immersing nipple in a shot glass of warm water- wet cracks reopen less painfully than dry ones
    - use combination of 1% hydrocortisone cream and bacitracin antibiotic ointment on crack to combat inflammation and infection. Use pea-seized amount, mix and apply using clean finger.
    - See another LC, preferably an IBCLC- each one has slightly different tricks and may pick up on an issue the other missed
    - make sure your baby is checked for a tongue tie and high palate
    - talk to the LC about the "nipple sandwich" technique- often useful for cramming maximum breast into tiny mouth
    - experiment with different nursing positions- one may work better than the rest. I nursed my first in the side-lying position because that enabled the deepest latch. Many other mamas have more success with the football hold.

    The second thing I am thinking is that you might have thrush, in which case you want to not use any moist healing techniques. Breast pain, particularly deep pain + cracked nipple can indicate thrush. So make sure you talk to the doc and the LC about that possibility, and do your own research (LLL has great info, as does kellymom.com). Many docs and LCs do not realize that thrush can be present even without the classic symptoms, or that both members of the nursing pair must be treated even if one is asymptomatic.
    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!"

  4. #4

    Default Re: Sever breast & nipple pain - no help from Doctor

    I was thinking thrush, too, which is why I went to my OB. But she said she doesn't think it is because of no visual signs on me or baby. I've read since then that you can have a yeast problem w/o outward signs. I've had days that don't have as much pain though, and I think it'd be constant. I'm going to give it a couple more days of light pumping on the injured side to see if it gets better.

    Any thoughts about why I'm only getting milk from one pore? It's been that way since he was born (I was pumping in the hospital). My left breast has always been my "good side", but I haven't had just one stream of milk on my "bad side" when I BF my other children.

    Trying to stick it out because I know it's the best thing for him, but yes - at the moment an electrical outlet sounds more appealing

  5. #5
    Join Date
    Mar 2006
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    10,440

    Default Re: Sever breast & nipple pain - no help from Doctor

    I got fed up and treated myself with clotrimazole cream, aka Lotrimin, when I had a stubborn yeast infection and everyone said I didn't. it works better if you can get someone to treat baby too at the same time though.

    I would imagine, from the description of your nipple, that something is off about the latch that is causing the pain and cracking and probably even the blood.

    The one pore thing...I've heard of that before. But we never did nail down a reason. Is your supply Ok on that side?
    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. #6

    Default Re: Sever breast & nipple pain - no help from Doctor

    I have been thinking my supply is low, but after doing some reading I'm not so sure. I have been supplementing w/formula. He was born 3 weeks early & weighed 5 lb 10 oz. He lost a little and gained it back quickly. Now he's somewhere around 7 lbs - I'll know for sure next week. He's almost a month and a half old now. I get around an oz from that breast when I pump and 1-2 from the other. My other kids were full term and on the large side (both almost 9). I was constantly getting engorged, feeding, pumping, repeat. I never feel engorged this time around. I'm not sure if that's just because he was early or if it's because I've BF two other kiddos.

    Any ideas about why I only have one stream or how to fix would be appreciated!!

  7. #7
    Join Date
    Sep 2011
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    14

    Default Re: Sever breast & nipple pain - no help from Doctor

    I had the same problem with only one stream - sorry, i didn't get to the bottom of it but just wanted you to know you're not alone.. When I posted my question on this forum about the single pore problem someone posted a response saying they had the same problem but their milk output was fine (baby putting on weight etc). It's interesting that you didn't have this problem with your other kids - maybe that implies that there is something about this baby's latch that isn't opening up all the pores?? For me it's my first baby so I can't compare, but in the early days my nipples were pinched and the whole experience was agony for weeks - i ended up using nipple shields but that still didn't stop the pain. In hindsight I think the issue was a bad latch followed by a case of thrush - and i have often wondered if a bad latch somehow didn't open the pores right in the beginning (not sure why they wouldn't have opened up later, my theory is not without flaws!). Anyway, I was able to increase my milk supply (to the point of feeling engorged) through regular pumping, acupuncture - various points on your back, legs and hands - and more nursing tea than i ever hope to drink again.
    I hope someone else is able to shed more light on the single pore issue. With two other kids to care for I really take my hat off to you - I worry about how i will breastfeed my next baby with a toddler running around. Wishing you the best of luck xx

  8. #8
    Join Date
    Jun 2009
    Posts
    5,301

    Default Re: Sever breast & nipple pain - no help from Doctor

    If you want I can post your ? about milk coming from one pore on my local Leader online chat, in my area we have some really long time Leaders and Leaders who are also LC's and someone may have an answer. But I need your permission.

    Off the top of my head I don't see how much it would matter. As I recall, when I pumped it looked like milk 'sprayed" from only 2 openings on one side and three on the other and I had major oversupply. But I really do not know for sure. I do know (because I just looked it up) that the range of nipple pore # varies quite a bit from mom to mom, it normally varies from 4 to 18 and some pores are present that do not connect to functional milk ducts.

    Also how much you can pump is not good indicator of how much baby gets when nursing, as most babies extract milk much better than even the best pumps. And you are getting a normal to good amount of milk when pumping from both breasts- more from one than the other, but even an ounce total from both breasts is considered a normal pumping amount for a mom who is also nursing regularly. So if you are saying you are pumping 3-4 ounces per pumping session while also nursing I also question whether the issue is low supply.

    Also slow weight gain can mean other things besides low milk supply. A baby (esp a small premature baby) may have difficulty transferring milk well, at least at first. He may be more sleepy and not nurse often enough or long enough.

    When you see the LC, how long is the appointment? Does she take any more info? Offer any suggestions? If the latch is so great, what is her explanation for the pain?
    Has she or anyone examined baby for tongue tie? Has anyone suggested you get a culture done to rule out a bacterial infection on the nipple? Thrush is way over diagnosed so I hate even mentioning it, but it should at least be considered. Any discussion of that?

    How many times a day are you nursing? Up until 6-8 weeks it should be at least 10-12 times a 24 hour day. I wonder if there is a way to hang up the pump and just nurse, which probably would help with the exhaustion if nothing else...

    And a very heavy period at this point seems a tad unusual. My understanding is the minipill can cause spotting. And although it is considered much safer for milk supply than combo pills, many moms DO report it affecting milk supply so...idk. Any chance you can use a non-hormonal bc method just until you figure out what is going on?

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