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Thread: Nipple pain and cluster feeding

  1. #1
    Join Date
    Sep 2012

    Default Nipple pain and cluster feeding

    My daughter is 4 weeks old and so far we've been doing well breastfeeding. She spits up a lot and cluster feeds during the day quite a bit, but until today it wasn't really an issue. Today, however, she was fussier than usual and cluster feeding, but would fall asleep after a few minutes on the breast. When she did spend any length of time on the breast, she would spit up (seemingly) most of what she took in and then want to nurse again. When falling asleep on the breast, however, her latch would get lazy and became increasingly painful as the afternoon wore on (despite my breaking the latch and trying again). We repeated this cycle for hours.... nurse, spit up, nurse, fall asleep for a few minutes, spit up, nurse again.... By 6 I was practically in tears... My letdown was incredibly painful and just having her on the breast was making me tear up. My husband has had to warm up frozen breastmilk to feed her because I just couldn't do it.

    I have an appointment with my doctor this coming week (she is both my doc and my daughter's ped) and I plan to call the lactation consultant tomorrow to get some advice, but my question is really multiple questions...

    First, could she be spitting up because she's not really hungry but just comfort feeding? If so, is there anything I can do to avoid this cycle?
    Second, what can I do about her sleepy latch? She'll relatch well but then slowly it gets more shallow as she gets sleepier.
    Third, is it possible I have thrush without her showing any signs? I have a rash on both breasts that my doc and I thought was caused by my daughter's nails scratching me and it seems to be clearing up with antibiotic ointment, but I'm worried about thrush too since I have painful letdown in general and I read that can be a sign. For what it's worth, my nipples are totally normal looking and my daughter has no signs of thrush. It's just the rash on my breasts (not on the areola or nipple) and the letdown pain that made me think thrush could potentially be involved.

    Sorry this post is all over the place. I've never felt this kind of pain before while nursing and I found myself avoiding my daughter's feeding cues this evening, which made me feel horrible. So I'm both a bit of a physical and emotional wreck right now. Any advice would be appreciated.

  2. #2
    Join Date
    Jun 2009

    Default Re: Nipple pain and cluster feeding

    Assuming baby is healthy and gaining appropriately...

    The cluster feeding and spit up is not a problem. That is normal breastfeeding behavior in the newborn period esp. Babies nurse for both food and comfort and so-called 'comfort nursing' is not only normal but usually needed for baby to get enough milk overall and properly stimulate good milk production. The problem is the pain you are in. That is not normal.

    I hear 2 different issues-latch pain, and let down pain.

    first- latch pain-so the latch feels fine at the outset, but gets painful later in the nursing session? There are a couple reasons this could be happening that I am aware of-

    1) gravity is pulling baby off the breast during the nursing session. This could perhaps be helped by adopting a more 'laid back' nursing position.

    2) your baby has tongue tie and gets tired from trying to extract your milk with a tongue that does not move as it should and when baby gets fatigued that makes the latch shallow and thus painful.

    Now- let down pain- some moms do not feel let down at all. Some do, and some feel it as painful. I have painful letdown sensation myself. It really stings, but only briefly. Personally, I believe my let down pain is linked to the fact I also have overproduction and forceful letdown. In my experience, it does lessen over time, as milk supply regulates and stops being so much.

    If you have overproduction, that could also explain lots of spit up (which again, can also just be normal) and it might also cause baby to adopt a shallow latch to slow down milk flow, although more typically, it causes baby to clamp down, which of course also hurts mom.

    Thrush may be asymptomatic in baby, However, thrush more typically presents as painful throughout the entire nursing session, and also, often, painful and/or itchy at other times as well. Visually, typical thrush in mom makes the nipples and areola look pink and shiny or pink and scaly.

    I suggest, if possible, seeing an IBCLC to have latch assessed and maybe to have tongue tie considered (you would have to see an ENT, dentist, or pediatrician who is conversant in TT and it's impact on breastfeeding to diagnose and treat it.) Make sure your IBCLC is experienced in latch issues and possible tongue tie. If you cannot see an IBCLC, (and even if you can) I suggest trying to meet with a local LLL Leader.

    One weird idea-breast compressions to keep baby nursing more actively so baby does not get ‘lazy.” I have no idea if this would help in your case, just a thought.

  3. #3
    Join Date
    Sep 2012

    Default Re: Nipple pain and cluster feeding

    Thanks for the advice. She's been a lot better since I started using lots of pillows, etc. to make sure she's not dragging my nipple down. I've also been consistently correcting her latch when it feels painful (instead of letting it go when we're both tired), and that has helped a lot. I still have some residual pain I'll ask my doc about, but yesterday was almost entirely pain free and nursing today has been much better as well. Thank you again!

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