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Thread: Need advice-pumping to let torn nipple heal

  1. #1
    Join Date
    Mar 2013
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    11

    Default Need advice-pumping to let torn nipple heal

    Hello,

    My son is almost 5 weeks old. he has been a good nursling, only takes one side per feeding, both sides at night (then back to one side during the night). I am going on week 3 of having this awful tear at the base of my nipple on the right side. It is between the nip and areola. I had a plugged duct originally and became frantic bc it started turning red. I was having him nurse and changing positions a lot and I also pumped a few times after he nursed. I do not know if he caused the tear or if the pump did. He is an aggressive nurser at the start. I have been living on waay too much ibuprofen to allow him to nurse and when it wears off it hurts soooo bad. I have APNO and had been using it until I saw a Pediatrician/IBCLC who recommended just straight bactroban bc she thought the steroid component could delay healing and there are no signs of thrush. She observed his latch, which is good. It just won't heal. I cannot get him to latch on in any position without it hurting so bad and ripping back open. The dr. I saw also gave me a pair of angled flanges, which are very comfortable to pump with...minimal pain on the tear. So today I started pumping that side and giving him my milk w a bottle ( he takes it semi-decently, some choking, but he chokes at the breast a lot too). Even thouh he takes one side per feed many times, the LC recommended at least offering the second side, if he doesnt want it, fine. She said he'll probably start to take second side as he gets a little bigger. This leads to my main question: since he has been *usually* taking just 1 side per feed, is it ok to have a schedule (ish) like:

    8:30 left side
    10:30 pump right, give bottle
    12:30 left side
    3:00 pump right, give bottle

    Or should I be pumping that right side every time, just for a shorter duration when he mainly feeds on left? Today so far for both pumping sessions on the right side, I got 2.5 oz, he took it all by bottle both times, then zonked out so I didn't bother offering left side.

    I get super nervous about my supply being impacted negatively. I am going back to work in 3 weeks, so I will be pumping and he will be on the ebm bottle while I'm at work. My hopes are to allow this tear to heal and just nurse him when I'm with him, like I have my other kids, and only pump/have him on bottle when I'm at work (not including the practice bottles leading up to my return to work).

    Any suggestions or advice is so much appreciated!!!

  2. #2
    Join Date
    May 2006
    Posts
    20,960

    Default Re: Need advice-pumping to let torn nipple heal

    With the choking and one-sided feedings, I have to wonder if perhaps you don't have some oversupply in the mix. Do you ever see any of the following:
    - frequent feelings of fullness/engorgement
    - strong letdown sensation
    - lots of leaking
    - baby chokes, coughs, splutters, or clicks while nursing
    - if baby pulls off the breast while nursing, you may see milk stream or squirt from the breast
    - mom may be able to pump multiple oz of milk with ease (if you have started pumping, how much are you getting?)
    - baby may gain weight rapidly
    - baby may be extremely gassy, poops may be greenish and explosive
    - baby may feed rapidly, in as little as 5-10 minutes
    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!"

  3. #3
    Join Date
    Dec 2009
    Posts
    177

    Default Re: Need advice-pumping to let torn nipple heal

    Sounds like the situation I was in. I don't have much advice but I can tell you waht happened to me. I let my left side heal "trying to" pump on that side every time DD2 fed from the good side. I was not sucessfull in pumping every time and ended up lop-sided by the time I started nursing on that side again. So at 5 months I have oversupply on my right side and undersupply on my left. When I'm nursing I offer the weak side first, then the full side. All I can say is that the injured side has to be stimulated every time the baby nurses or you will see a decline on that side. Sorry I'm not much help, but good luck with the healing. I used soothies on the injured side and that seemed to help.
    Trying to keep up with a busy 3.5 year old Morgan Alexis born 11/5/09 at 6 lbs 5 oz and proud retired 1 year EP'er!

    Nursing our new addition Jordan Catherine born 10/21/12 at 7 lbs 14 oz.

    Total donated milk so far - 1,368 ounces!

  4. #4
    Join Date
    Mar 2013
    Posts
    11

    Default Re: Need advice-pumping to let torn nipple heal

    I definitely had/have most of the oversupply issues you have described. I feel like things are evening out more now...a few days of dealing with the oversupply again after his 3, well more like 4 week spurt. He is very gassy and has explosive poops that are usually yellow sometimes yellow-greenish. In the earlier days, there were many times that I'd put him on the same side twice instead of offering the second side because of this. I even still will put him on same side twice if he falls asleep really fast and hardly nurses. I do have a strong let down, but just fast drips now, no squirting. He does feed very fast, in 5-10 minutes. He has episodes of stridor while trying to organize his sucking and breathing with the fast flow, which ends up with the choking. He is on Zantac for having lots of reflux symptoms, although I haven't been able to give it as often as prescribed because he throws an absolute fit - its not worth it for me to do that in the middle of the night! In the evenings he has crying jags and nursing is the only thing that soothes him, he will be so happy to latch on but then 1 minute later he is arching and pushing and pulling...comes off, them wants back on, etc etc. I think he wants to just suck without the swallow, but I continue to get let-downs, so it just isn't possible. I finally caved and gave him a paci a few days ago, but he hated it (soothie). Today I tried an orthodontic shaped Tommee tipee paci and he kind of liked it, it put him to sleep.

    I'm just afraid that with things starting to even out, he will want both sides and I won't have enough supply bc I was only pumping /offering one side. My last pump session on the right side yielded 3oz. In less than 10 minutes. He took 2from bottle, dozed a while, then took the 3rd oz. Then wanted to nurse on the good side an hour later, which is kind of typical for him in the evenings. It certainly is much easier to stick with one side per feed at this time to allow more rest and healing on the bad side. The pump still aggravates the tear, just not nearly as bad as when he nurses. I did let him nurse on bad side twice in the night... It's just such so much easier and I thought I'd give it a try to see how bad it hurt after only pumping that side all yesterday. Still hurts bad!

    I have been pumping 1oz after his morning feed on the good side to get a stash for going back to work.

    He was 6lbs 2oz at birth, 38.5 weeks. He was 9lbs 5oz at his1 month well visit on the 18th (Monday).

    My now 3 year old used to take the second side, but only for a very short time. Early on with her too I had oversupply and would often not make it to offering second side, but she eventually did take it as she got older.
    Last edited by @llli*kalinky; March 22nd, 2013 at 07:18 AM.

  5. #5
    Join Date
    May 2006
    Posts
    20,960

    Default Re: Need advice-pumping to let torn nipple heal

    Okay, since you still have a ton of oversupply symptoms, I am going to say that it's probably okay to not pump the right every single time, although ideally I think you should. I think that because you are returning to work, you want to be careful to maintain supply on that side, but you don't need to go crazy, pumping to the point of emptiness every time. I think that in your shoes, I would try to take 1-2 oz every time the baby takes the left breast, and 2-3 every time the baby gets the bottle. Another reason to keep on top of the pumping while you're not using the hurt side is that if there's some underlying infection on that side- something which I think is an extremely good possibility because of the plugged duct, redness, and position of the tear- you want to keep milk moving on that side. Letting milk really build up in the breast is going to increase your risk of mastitis- and you don't want that problem on top of what you already have!

    Do keep on with the antibiotic ointment. I really think that infection is a real possibility- you had 2 weeks of no problems and suddenly this big crack pops up, in a place where women don't usually get cracked when the problem is the baby's latch.
    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
    Join Date
    Mar 2013
    Posts
    11

    Default Re: Need advice-pumping to let torn nipple heal

    Ok. Your info makes good sense. It's so hard to know when to pump with his feelings not being very regular...a half hour between feeds sometimes, two hours other times. The average is two hours but it varies so much! We will persevere and try to get this tear to heal up! Thank you so much for your advice!
    ~Sarah, momma to
    Gracie 7/2006
    Keira 12/2009
    Parker 2/2013

  7. #7
    Join Date
    Mar 2013
    Posts
    11

    Default Re: Need advice-pumping to let torn nipple heal

    Hey mommal (or anyone with advice), I have another thought brewing in my head...to try to make this a little more consistent, what do you think about pumping the right (torn) side every 3 hours til empty, then having him alternate feeds:

    L side until finished then offer 1oz bottle
    bottle of 2.5 oz, then offer L breast

    I feel like this might be a little easier to make sense of since his feed times vary so much. What do you think?
    Last edited by @llli*kalinky; March 22nd, 2013 at 11:09 AM.
    ~Sarah, momma to
    Gracie 7/2006
    Keira 12/2009
    Parker 2/2013

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