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Thread: Vasoplasm?

  1. #1
    Join Date
    Aug 2014
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    Default Vasoplasm?

    This is the second thread I've started here. The first one was about dealing with cracked nipples (one far worse than the other). I went to see a Lactation Counselor who said there was nothing wrong with my latch and no tongue tie. She suspected that the nipple shield I was using was too small still (in the hospital they had given me the smaller size and I ended up with blisters). I went up another size in the shield along with getting a prescription for Dr. Jack Newman's nipple cream and things seemed to be getting much better.
    I started noticing that my nipple was white shortly after the baby finished. I also noticed that if I got cold, i.e. my nipples were hard, they would hurt. The pain started shortly after feeding and would last for awhile.
    at first it was just a minor discomfort, now it is getting to the point where I am in a lot of pain. It does not hurt to nurse, but the pain starts shortly after he is done. It is extremely painful if he comes back to the breast shortly after nursing (like if he falls asleep then wakes up again in 15 or 20 minutes).

    I started googling and came across nipple vasoplasm. It said it can be caused by trauma to the nipple and may continue after the source of the problem is fixed. I have tried a number of the suggestions I found online, olive oil, keeping them warm, etc. but am still experiencing pain.

    I am beyond frustrated. LO is 4 weeks old now and I have been in pain pretty much the entire time. I just started feeling better and the pain starts again. I don't know what to do.

    How long will this take to heal?

    As for the nipple shield, the lactation counsellor wasn't concerend about me using it. I've read up online about how to break from using it but nothing seems to work either. I have flat nipples and cannot get a latch at all without it. He is gaining weight very well and have normal diaper out puts.

    I really don't want to give up but am getting to the end of my rope.

  2. #2
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    Jun 2009
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    Default Re: Vasoplasm?

    Hi!

    I am so sorry you are so understandably frustrated. I know a little bit about what you are experiencing- With my oldest we had terrible latch issues and I used a nipple shield for about 4 weeks on one side and 6 on the other. I had terrible nursing pain, nipple injury, the works. Ultimately I went on to nurse my son for years, pain free. But it did take lots of effort, tears, and frustration and seeing two different (both very good) Board Certified Lactation Consultants (IBCLC's) to get through it.

    Well, the white nipples after nursing and cold reaction certainly does sound like vasospasm. From what I have heard, vasospasm can REALLY hurt. Does warming the nipples (say, with your palms or a warm washcloth or something) after nursing help with the pain any?
    If it is vasospasm, then the question becomes, why is vasospasm happening? It can be related to thrush, according to Newman. It is also certainly related to clamping and/or a poor latch. In other words, while some moms do seem to be prone to vasospasm, and some even have something called Raynauds Phenomenon that you will want to read about, (see link below) there is usually something else going on.

    What I am not happy about is that you are being told there is nothing wrong with your babies latch, and yet you are using a nipple shield. While there are other reasons a mother might use a shield, they are designed for what you are using it for- to help a baby who is having so much trouble with latch they cannot nurse without one, to be able to nurse. So, if you are using a shield because baby cannot nurse without one, then obviously latch is not fine! This does not mean don't use the shield! It is good you are nursing baby at the breast, very good. But it is not very good that you are struggling with so much pain at this point. Yes, an incorrectly sized shield might cause additional issues, but I cannot help but go back to why you (or rather, your baby) needs a shield to nurse in the first place.

    When a mom has "flat" nipples, (that is what they told me too) there are a few things to know. One is, this is not necessarily a barrier to a baby being able to latch. 2) this is usually temporary, and mom nursing and pumping will typically "bring the nipple out" Also, as baby gets bigger, their ability to latch usually improves. Your baby is a month old. Is latch improving do you think? Is it getting easier to latch baby on, for example?

    The other important piece is that any engorgement or even overfullness exacerbates flat nipples, because these make it hard for baby to latch. Are you having any issues of engorgement or feeling very full between nursing sessions? What have you been trying as far as latch and positioning?
    Are you pumping? This is typically recommended when shields are being used, although how often or even if a mom always needs to pump in that case will vary. Did you discuss pumping with your LC?
    http://www.breastfeedinginc.ca/conte...ename=doc-V-RP

  3. #3
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    Aug 2014
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    Default Re: Vasoplasm?

    Thanks!
    Someone in my previous thread posted a link for IBCLC's but it appears there are none in my area.

    Warming the nipples right afterward does help.

    I've tried to bring the nipple out. After using the shield for a few minutes, my nipple is larger (it still doesn't look like most others do I don't believe), so I quickly switch it out and have not been able to get him to latch. I've also tried ice or to bring it out myself.

    I honestly can't tell if his latch is getting better. It seems fine from what i can see. I also assumed it was fine because I started to have pain free feeding sessions.

    I don't feel overly full between feeding sessions but he has been nursing a bit more lately, definitely not engorged. I am pumping, but mostly just when he is given a bottle for some reason (I had been replacing feeding on one side with a pumped bottle to allow the crack to heal) and I'll pump one side in the morning, he feeds off the other (he only does one side at a time most feedings).

    I did mention to the LC that I was pumping to avoid feeding on the sore side and asked about how often I should be pumping. She just said whenever he would be feeding from that side. She didn't get into much more detail. Since I healed, he still gets one bottle a day and I pump when he is given that.

    The LC was very nice but she didn't seem to have a lot of the answers I was looking for. Unfortunately I don't know where else to turn.

  4. #4
    Join Date
    Mar 2014
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    Central FL
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    Default Re: Vasoplasm?

    When using shields I believe that since they can interfere with milk transfer some and affect the way the stimulation of the breast happens they can cause milk supply to diminish over time so that is part of why pumping would be recommended when shields are used, to make sure you don't have a low supply problem over time.

    This site is a good resource as well as many of the links provided like to the IBCLC sites and IBC (Dr Jack Newman's site) and KellyMom and Low Milk Supply.org and feed the baby. You might also see if there is an LLL in your area.

  5. #5
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    Jun 2009
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    Default Re: Vasoplasm?

    Yes agree with tclynx, pumping when using shields is suggested in order to protect milk production (and to provide milk for baby if baby is unable to transfer enough at the breast when using shields) How often depends on many factoirs, it can be as often as after every nursing session but that is not always needed (and indeed could cause overproduction) Unfortunately it really depends on how severely impaired milk transfer is by the shield (or whatever is causing the need for the shield) so it is hard to say exactly how much a particular mom should pump, but that is why a mom using shields SHOULD (Ideally) be closely monitored by someone who knows how to monitor baby intake and milk production. Luckily your baby is gaining well so that is being watched, but unfortunately that does not mean that milk production long term may not be in trouble.

    See more in article on shields I link below.

    OK, so the person you saw was not an IBCLC? Was she a LLL Leader or ? What credential did she have? I am not sure why she was able to diagnose baby as not tongue tied if she was not an IBCLC. This is a diagnoses, as much as saying a baby IS tongue tied is. Actually this is a diagnoses that ideally comes from a pediatrician, or dentist or ENT, typically. Although in many cases even those professionals are not aware of the latest thinking about tongue tie and lip tie and how it affects nursing.

    If you can tell us generally where you live, (generally, not specifically,) maybe we can investigate and see what resources may be around you. If you prefer, you can PM me with that info.

    It is good the pain was getting less. That is a good sign that latch was improving, but it is still not 'there' yet, or your baby would be able to latch without the shield (it can take some work to encourage baby to do this) I am wondering what you are doing to help baby latch, either with or without the shield? Breast sandwich? What about positioning? It would help to know what you have tried and what seems to work best, what seems like it might work but does not, etc.
    Babies nurse just fine on breasts and nipples of all shapes and sizes. And sometimes babies are not able to latch on breasts that look 'breastfeeding perfect.' So Try to not compare yourself to others, anatomically. that is not going to give you information that will help in most cases.

    nice article with different ideas for latch and positioning. http://feedthebabyllc.com/latch-and-positioning/
    and weaning off nipple shields: Again, I am not saying you have to wean off the shield immediately. but if the shield IS causing the problems, it makes sense to keep trying to wean baby off, I would think? http://kellymom.com/bf/concerns/child/wean-shield/
    Last edited by @llli*maddieb; September 1st, 2014 at 09:24 PM.

  6. #6
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    Aug 2014
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    Default Re: Vasoplasm?

    No one mentioned anything about pumping to keep up supply. At this point, i don't think it is an issue. I am getting anywhere from 4-6 ounces per breast depending on time of day and how long it has been since I pumped. I was actually worried about pumping too much and ending up with an over supply issue.

    I checked my area for a LLL. It appears we have one, but the meeting date listed is from months ago. I cannot find a location or any contact information for anyone locally. The site takes me to a main page that gives me the info for the main one in this province. I have already phoned and left a message with that person to get local information. i did not get a call back.

    I also joined a Breastfeeding support group locally, however, it is not exactly what I expected. It is not lead by anyone with experience that I can ask questions.

    The person I saw was not an IBCLC that i know of (when I searched the link someone provided there were none in my area). She is a nurse with the hospital.

    I don't really know what you mean by helping the latch but by your link, I do the nipple tilt. I've tried the sandwich, especially when trying without the shield. The positioning is either the normal, across the body one or the football hold. I don't really know anything else.

    The Kellymom article is the one I have tried the suggestions to get off the shield without success.

    I thank everyone for all the help, however, it is looking to me like this just isn't going to work for me.

  7. #7
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    Aug 2014
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    Default Re: Vasoplasm?

    Also, when I mentioned I had read about concerns with milk transfer and the shield, the LC said that that was more of a problem for older type shield and it really isn't a concern.

  8. #8
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    May 2006
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    23,786

    Default Re: Vasoplasm?

    Quote Originally Posted by @llli*runbabyrun View Post
    Also, when I mentioned I had read about concerns with milk transfer and the shield, the LC said that that was more of a problem for older type shield and it really isn't a concern.
    I don't buy it. Yes, the older shields were worse in this regard, but the new shields aren't perfect. Milk transfer issues are always something to look out for when a shield is in play. Besides, a mom is only going to use a shield when the baby is having some sort of problem latching- and that can lead to transfer issues even before a shield is introduced.

  9. #9
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    Central FL
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    Default Re: Vasoplasm?

    Quote Originally Posted by @llli*runbabyrun View Post
    I checked my area for a LLL. It appears we have one, but the meeting date listed is from months ago. I cannot find a location or any contact information for anyone locally. The site takes me to a main page that gives me the info for the main one in this province. I have already phoned and left a message with that person to get local information. i did not get a call back.
    Keep trying.

  10. #10
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    Jun 2009
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    Default Re: Vasoplasm?

    Call a neighboring group? Sometimes Leaders retire and Groups disband, but like everything else the info stays on the internet forever.
    What public Health services do you have access to?
    Any breastfeeding coalitions local or not so local? There might be one for the whole province or country.
    Did you ask your baby's pediatrician, your OB, or your hospital if they can refer you to an IBCLC or to someone who diagnoses oral issues that affect breastfeeding?

    Mommal is correct. Yes the silicone shields are better than what was used previously, but the use of even these shields has been shown to be connected to low milk production over time. The problem is, it is hard to identify who will have an issue, There are other factors at play. Yes, four ounces a pump session is a good amount, and your baby is gaining normally. So you do not have a milk production issue YET. It takes time for milk production issues to happen.
    You are pumping some, right? So that is good. Another possibly helpful idea would be to encourage baby to nurse frequently. This also helps with latch issues because the softer the breast, usually the easier to latch, and because nursing often helps baby not be frantic at meal times and a calm baby is more willing to try different approaches to latch.

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