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Thread: Still having problems with cracks and soreness!

  1. #1
    Join Date
    Aug 2012
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    Default Still having problems with cracks and soreness!

    I've been breastfeeding my 2 1/2 month baby since birth and I'm still having problems with cracks and nipple soreness. He had a tongue-tie clipped the first week, I got mastitis, and 2 weeks ago treated for yeast which seems to have cleared up. Also, a LLL leader visited me and helped me get a good latch. He's been latching great, but I'm still having problems with general nipple soreness, and worse yet, one nipple has a horrible crack which bled today during nursing. I can't seem to get this healed up! I'm using a "tripple nipple" ointment (has antiboitics, antifungal, and anti-inflammatory, like the APN recommended by Dr Jack Newman) and change nursing pads after every feed.

    The pain and cracks are so bad that I feel like giving up breastfeeding, especially when it bleeds and I see blood in the baby's spit-up . I don't want to give up because I know breast milk is best for him and he really likes nursing. What should I do? Continue on and hope things will improve? Try to pump for every feed? (I pumped for several feeds today just to get some relief). Try a nipple shield? Need some help! Thanks.

  2. #2
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    Default Re: Still having problems with cracks and soreness!

    Ouch!! I'm sorry you're having so much trouble! The fact that your nipples are still so sore and bleeding suggests a couple of possibilities to me: (1) Your latch is still bad, possibly because the tongue tie was not completely clipped; or (2) You still have thrush, or you are still healing from the damage done to your nipples by the thrush; or (3) You have some other kind of infection, possibly bacterial, on your nipples.

    All of these scenarios pretty much require that you seek additional medical or IBCLC help. I would probably seek a second opinion from an ENT on the tongue tie, and see an IBCLC as well. Your doctor might also be able to culture your nipple to see whether you have another kind of infection.

    In the meantime, I wouldn't stop nursing entirely, but pumping for a few sessions a day could give you much needed relief. Don't stop nursing entirely because you don't want your baby to forget how to latch, and too much bottle feeding could worsen a bad latch.

    Can you see an IBCLC? That's probably where I would start. LLL leaders are a wonderful resource, but you need a little more expert help here. The IBCLC will hopefully look for tongue tie, check your latching technique, and evaluate your symptoms. She will probably give you a better idea of where to start trying to get some more help.

    But definitely don't give up! All of these issues can be addressed, and even if your baby is still tongue tied, it's likely that his latch will significantly improve as he gets older and his mouth gets bigger. Pump if it is less painful, to let your nipples heal, but getting through these issues and continuing to breastfeed will be so worth it, trust me.

    P.S. It's alarming to see blood in a baby's spit up, and it's certainly painful for you, but it doesn't hurt your baby.


    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
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    Default Re: Still having problems with cracks and soreness!

    I did see a pediatrician and IBCLC nurse a few weeks ago, and they agreed the tongue-tie was resolved. The nurse was the one to diagnose the thrush and suggest the gentian violet treatment per the Dr. Newman method.

  4. #4
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    Default Re: Still having problems with cracks and soreness!

    So you've completed the gentian violet treatment? If that hasn't resolved your nipple pain and bleeding, I'd suspect a bacterial infection. A doctor can actually culture your nipples and see what type of infection you have (if any). It's not super common, but staph and other bacteria can cause terrible nipple infections that are not resolved by other treatments.


    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
    May 2006
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    Default Re: Still having problems with cracks and soreness!

    Joe.s.mom gave excellent advice and information, as she always does.

    I'm curious about a couple of points about your baby's latch. First, how does the latch feel? It's very common for the latch to look fine on the outside but feel terrible on the inside- and it's what the latch feels like that matters. Second, when baby is finished nursing, what shape is your nipple? Is it symmetrical, like a pencil eraser, or asymmetrical/wedged/ridged/creased/shaped like a new lipstick?

    A few more things you can do to cope with cracked skin in the nipple area:
    - Go topless/braless as much as possible to reduce chafing to already-sore nipples
    - Practice rigorous hygiene
    - Keep the humidity in your house high, use gel pads for the cracks, keep using the ointment- the moister the skin the easier the healing process (usually- this is not necessarily true when there's bacterial or fungal infection)
    - Before latching baby on, immerse your nipples in a shot glass full of warm water to hydrate the scabs on the cracks. Softened scabs tear open less painfully than dry ones.
    - If the latch is uncomfortable, experiment with different positions until you find one that works better than the rest- don't worry, other positions will come in time as your baby grows!
    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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    Default Re: Still having problems with cracks and soreness!

    The latch is ok, but not the "perfect" way that breastfeeding books describe. I've always had creases on both nipples. The R looks kinda like a new lipstick, while the L is more symmetrical, but both have the crease that runs across the top. Right now, the R side feels ok when he's latched and nursing, but the L side hurts due to the deep crack (which runs across the top where the crease is) and a small wound on the side (how that happened, I don't know, it just looks like a small circular chunk of skin is missing), both bleed sometimes. I try to get a good latch on both breasts, have read all the articles from kellymom, but still get the creases and sometimes a feeling that his latch is a bit shallow, especially on the lower jaw. Also, after feeding on the L side, I get pains in that breast; this has always happened, from the first few weeks. I thought the pain was due to yeast, but after multiple treatments of fluconazole, I'm thinking that there is another explanation. The L side produces a lot more milk (when I pump its 3 or 4 times as much!).

    I was treated for yeast about 2 weeks ago--fluconazole for 14 days and did gentian violet for 5 nights. Previous to that, I was treated for staph found in a breast milk culture, and about 2 months ago I took antibiotics for mastitis on the R side (had cracks on the R, bacteria probably entered, I was only using lanolin at that time). Also when I was on antibiotics both times I took fluconazole, the second time for 14 days again. I've taken so much medicine that I'd like to think that the yeast and bacteria are gone, but I guess only a Dr could say for sure.

    Any suggestions you have would be great! I have a strong desire to keep breastfeeding, and I would really like to enjoy it rather than experience pain.

  7. #7
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    Default Re: Still having problems with cracks and soreness!

    Also I was wondering if it is a latch problem, which I suspect it is, is it too late to change my baby's latching habits? He's 11 weeks, and I feel like every time I try to reposition him to get a deeper latch, he latches just the same way. Since he gets a lot of milk regardless of how good the latch is (he's very chubby!), I feel like he isn't inclined to change his position no matter how hard I try to make him. Taking him on and off the breast usually just upsets him and he cries hard until I put him back on.

  8. #8
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    Default Re: Still having problems with cracks and soreness!

    Never too late! It's very likely that even if you do nothing, this Situation will improve, since babies generally get much better at latching as they grow. A bigger mouth and better muscle control, better head control- those things usually add up to a deeper, better latch.

    Since you're still getting creed, lipstick-shaped nipples, it's very likely that there's still something off with your baby's latch, no matter how good it looks on the outside. Compression due to a imperfect latch can cause something called vasospasms, which cause pain which is often mistaken for thrush. Here's a link: http://kellymom.com/bf/concerns/moth...ple-blanching/.

    However, since you know you've had both thrush and a bacterial infection, I'd consider going back to the doc for a second culture. Maybe that bacteria didn't get beaten with the first round of antibiotics.
    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!"

  9. #9
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    Default Re: Still having problems with cracks and soreness!

    with PPs. Since you say he's very chubby and gets enough milk despite latch, I wonder if forceful letdown might also be in the picture, since that can cause a baby to clamp down to slow the flow. http://kellymom.com/bf/got-milk/supp.../fast-letdown/
    mama to a little raccoon, born under the full moon, Nov '11

  10. #10
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    Default Re: Still having problems with cracks and soreness!

    Wow... aside from the infections...we are in the same boat. I have an 11 week old and still have chafed and bloody nipples and spasms abed shooting pain. Breastfeeding is so important to me even though I only make half of his needs. I am glad I haven't had infections as f ar as I know...but at least you make a full supply. I would use those expensive non sticky gel pads and pump for a few days with a hospital grade pump to heal up and you will be able to start up again and work on that latch. My sons tongue tie wasn't clipped because I waited stupidly listening to my pediatritian who said he would grow out of it...he did get better but now he has regressed and we are back to severe pain and deformed nipples and extremely bruised cracked bloody nipples....I wish I could get someone else to breastfeed him so I could have a break. Hang in there... your milk is worth it and your baby is worth it.

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