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Thread: Help help HELP PAIN!!!

  1. #1

    Default Help help HELP PAIN!!!

    Ok so I'll start from the beginning.

    Had to-term twins via c-section (both breach and history of Postpartum hemorrhage made c-section the safest route for us). C-section went well, I hemorrhaged in the recovery room. It was managed with deep uterus massage (constant for about 3 hours) and then we were out of the woods.

    Milk was delayed about 6 days. We did SNS in the hospital with doner milk, but coupled with both babies being tongue thrusters and my breasts being really soft and malleable they consistently pushed my nipple out of their mouths. This made for a very very sore me (eg toe curling, screaming into a pillow, trying desperately not to squeeze babies, pain) I should qualify this pain statement with the fact that I am highly HIGHLY tolerant of pain (2 natural child births, of meds 2 days after my c-section, gotten back on horses with pulled hamstring, hyperextended knee and shown in a horse show and won).

    So when we got home with the babies I turned to pumping which was marginally less painful than breastfeeding (once the cracked and bloody nipples healed that is) and bottle feeding the breast milk to the babies. From the beginning the supply hasn't been great. I've consistently produced about half of what they eat so I've been working diligently to up my supply. the pain that I experienced never really went away but it was tolerable'ish.

    Babies are now almost 8 weeks and after this last pumping session about 4 hours ago I'm in severe pain! breast tissue is painful to a light touch (and just painful sitting here) can't even put any pressure on my nipple at all. my whole right breast is screaming in pain and the left is mostly normal, I think that one is pain because the pain from my right is transferring.

    I really don't know what this is or what to do. I've had Mastisis with a previous pregnancy (we fed through it and cleared it up just fine) and this doesn't feel anything like it, I don't have any redness or swelling (though my breasts are starting to become engorged because I can't bear to pump!) I'm not running a temp

    Any advice would be so very very appreciated

    Juneberry
    Daughters 10, 8, 7weeks & 7weeks

    I should also mention my older daughters were exclusively breastfed with no problems.

  2. #2
    Join Date
    Mar 2010
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    Northern Cal.
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    4,983

    Default Re: Help help HELP PAIN!!!

    I dunno, I would definitely suspect mastitis, mama!! Just because you've had it before doesn't mean it couldn't hit you in a different way. The tenderness you describe sounds very much like the early stages of mastitis. Often the breast gets hot and painful before you get a temp. Even if it's not mastitis, I would treat it like it is right now, just in case. Get in a hot bath or shower and really massage that breast. Pump it and massage some more. This is painful, but you have to push through the pain a bit because full-blown mastitis is even worse.

    The other possibility might be thrush? That would usually be associated with a burning/itching pain, sometimes just on the nipple, sometimes throughout the breast.

    There may be other explanations for the pain you're experiencing, but given that it's only one breast, that it's extremely tender, I really think it sounds more like mastitis than thrush. I've had mastitis several times and it's not always exactly the same sensation. I'd try mastitis techniques and if those don't work, come back here, and definitely call your doctor.


    You can call me JoMo!

    Mom to baby boy Joe, born 5/4/09 and breastfed for more than two and a half years, and baby girl Maggie, born 7/9/12.

  3. #3

    Default Re: Help help HELP PAIN!!!

    I'm leaning towards thrush I think. Still no sign of any infection just severe burning pain through my whole breast. left breast is not without pain but it is just the nipple area not deep within the breast like on the right. Nipples have taken on a light pink shiny color. The pain has gotten slightly more bearable after an overnight exposed to air. but after pumping about 12 hours after the pain started, the pain is back and TERRIBLE again. It's the weekend so I'm not sure what exactly to do.

  4. #4
    Join Date
    Mar 2010
    Location
    Northern Cal.
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    4,983

    Default Re: Help help HELP PAIN!!!

    My suggestion would be to out and get some antifungal ointment at the drug store right away and start applying that. (I use clotraminazole cream.) Don't use soap on your nipples, but you can rinse with vinegar. You can also get some probiotics at a natural food store. You can get infant probiotic powder, or acidophilus in capsules (you don't need anything fancy or enteric coated, etc.). Break open the capsule and apply the powder directly to your nipples, and also take the pills regularly and put a little powder right on your babies' tongues (are you EP'ing? or nursing some? if you're nursing, you need to be treating both you and the babies, and it wouldn't hurt to do this anyway).

    A lot of women swear by grapefruit seed extract and/or gentian violet for thrush. I think both of these can be got without a prescription, as well. The best prescription for thrush is Diflucan, and if you can call a nurse/doctor, they may just call in an Rx for you.

    So, there are a lot of options for starting treating, even on a weekend. Hopefully you'll get some relief soon! Thrush is SO PAINFUL. So much sympathy!


    You can call me JoMo!

    Mom to baby boy Joe, born 5/4/09 and breastfed for more than two and a half years, and baby girl Maggie, born 7/9/12.

  5. #5
    Join Date
    Jun 2009
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    5,731

    Default Re: Help help HELP PAIN!!!

    So just so I understand-you are exclusively pumping? I assume you are using a hospital grade rental pump-and how often per day are you pumping?

    So what jumped out at me from your post is that the pumping was only "marginally" less painful than nursing from the start. This is a big red flag to me as pumping should not hurt-(although of course it often does.) Typically pain from pumping is linked to improperly fitted flanges or mom pumping at too high a setting. Poor pump performance could also lead to the breasts not being "emptied" properly by pumping which leads to all sorts of issues-low supply, engorgement, plugged ducts, mastitis. Also pumping can sometimes bring fluid into the areola and cause pain and issues that way-particulary if you are doing long pump sessions or pumping at too high a setting, or the flange is too large and pulling too much of your areola into the tunnel.

    A too small flange causes the nipple to rub against the tunnel causing pain that way.

    Ths is not to say the issue is not thrush, it could be, or thrush could happen in combo with the pump causing injury. When a mom is nursing thrush typically is present in both breasts, although maybe with exclusive pumping would change how infection happens(?)

    Can you hand express? This may allow you to keep getting milk out more comfortably while you figure out if the pump is part of the problem.

    See: http://www.llli.org/docs/00000000000...expression.pdf

  6. #6
    Join Date
    Jul 2012
    Location
    Western Pennsylvania
    Posts
    2

    Default Re: Help help HELP PAIN!!!

    I completely agree that this sounds like thrush. As I have had two babies and both times developed thrush directly after birth with both. This does not go away on its own, but only progress with increased pain, visible damage to the nipple, burning, everything you are describing. I have rid this a few different ways. As you are in so much pain, I know you are seeking this relief first...

    Option #1 - Over the counter option
    You can mix equal parts of each
    -Cortizone 10 Cream (rids itching/burning)
    -Anti-fungal Cream (Like Lotrim) Rids of fungal of thrush
    -Bactarin Cream (Heals damaged nipples)
    -For pain you can purchase advil liquid gel caps and cut open the gel caps and apply 2-3 liquids in the mixed cream.
    Store in a small air-tight tupperware container

    OR

    If you have a breastfeeding center close to you, I found more quick relief by seeing a lactation consultant who diagnosed thrush right away and prescribed me an all-purpose nipple ointment with tylenol powder. This provided a bit faster relief and they did also prescribe me with diflucan as the thrush had also caused me a yeast infection. They also included treating the baby with nystatin and I applied to my nipples as well. I quickly felt better and was cured within 2-3 weeks completely, but the relief was apparent much before. If you do not have a breastfeeding center near you, you might contact your pediatrician.

    I hope this helps!!!!
    Mamma of two girls and another on the way!!

  7. #7

    Default Re: Help help HELP PAIN!!!

    Thanks ladies, it has actually turned out to be both mastitis and thrush at the same time. After my last post my temp went from normal to 102 in a matter of hours, an angry red, almost bruise like patch showed up and I suddenly hit rock bottom. I ended up in urgent care so I could get started on antibiotics right away. Which of course won't help the thrush one bit I'll be seeing my LC early this week to deal with that issue.

  8. #8

    Default Re: Help help HELP PAIN!!!

    lllmeg, I am exclusively pumping but only with the Medela Pump in style advanced pump, my insurance wouldn't cover anything else, and I can't afford the rental on a hospital grade (well actually convincing the husband to pay for one more thing at this time especially when we already have a pump will likely be rather difficult) I pump about 6 times a day, I know I should be doing 8-10 or even 12 if I can manage but it's so hard with the babys this small, it seems I just sit down to pump and one baby starts wailing about something, so I stop pumping get that baby settled and hook back up to the pump and then the next baby starts crying.

    I end up doing far to long pump sessions if I try to pump at night because I'm so tired I'll fall asleep until the babies wake me up again. I once sat in the chair and slept for 3 hours while pumping (I know it's bad!) I run the pump in the lowest setting (it's all I can stand!) I'm pretty sure I have the right sized flanges, I did try one size up but they didn't empty my breasts well and really pulled too much tissue into them. I am having supply issues though. I can't seem to increase my supply past about 30 oz a day to save my life, so each baby ends up getting half formula and half breast milk.

  9. #9
    Join Date
    Mar 2006
    Posts
    10,440

    Default Re: Help help HELP PAIN!!!

    You pretty much HAVE to afford the hospital grade to EP. have to. It will be cheaper than formula for two babies.

    You also MUST pump 8-12 times a day. 120 minutes total, with more frequent and short sessions better for your supply. This is probably why you can't meet the babies' needs. Also, the pump might not be stimulating enough, and no pump is as good as a baby for your supply anyway.

    However, if you think EPing is hard now...just wait. It gets harder. In your shoes, I would find an IBCLC to help me nurse and not EP.

    I have four kids and have EPed for 18 months...hardest thing I have ever done, including veterinary school! Nursing will be much easier for a mom of twins in the long run
    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!

  10. #10
    Join Date
    Jun 2009
    Posts
    5,731

    Default Re: Help help HELP PAIN!!!

    Yes I am sorry your insurance does not cover the pump rental, but the fact is trying to ep with a personal use pump (designed to be used by working moms 2-3 times a day 5 days a week once thier supply is well established-and sometimes even THEN not effective enough to maintain good supply) is just never going to work. It's simply not the correct tool for the job. You may end up injuring yourself, at the very least you will almost certainly never build an appropriate supply, your supply will go down, and you will have no hope of producing enough milk for twins or even one baby this way.

    Frequent pumping builds supply. Frequent, shorter pumping sessions are what to aim for.

    Are you saying your insurance covered the medela, but not a rental pump? have you priced rental pumps in your area? Temporary rental of a few months is usually cheaper than the full cost of a medela P&S. It does not make sense. Were whoever sold it to you aware you were going to be trying to excusively pump for twins with it?

    Have you contacted you local Breastfeeding coalition? What about WIC in your area-do they have any lactation services? Sometimes these are resources for low cost or free pumps. (Yes even if you are not on WIC-sometimes.) Call around, call your local LLL Leaders, local LC's, your hospital, pediatrician, etc, here may be programs and options that are not well known and you just have to find the right person to direct you.

    Crunch the numbers for your husband, formula for a year with twins is going to be very expensive, and forget about it if one or both end up having issues with dairy and you have to find a specailized formula. Never mind the hidden, unknowable costs of health care for babies who may be ill more often or more severely.

    I agree the best option would be to get babies nursing at the breast, if that is at all possible.

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