RoadBlock...

[@llli*iritita]

I am feeling a bit at wits end. I have been exclusively pumping for about 5 weeks with a couple of BF sessions here and there. Recently (day before yesterday) I tried to BF all day with my LO. We had some bumps but eventually he latched on and drank his precious milk. At the end of the day my nipples were so sore and beginning to crack again. I feel like I will never be able to EBF and that is what I want to do. It would save me so much time and sanity from pumping all the time. Plus I LOVE the bonding experience that BF gives me and my LO. So after BF all day I was starting to feel a sharp pain in my breasts that would start at the nipple and shoot through my breast. It was so painful and now I have a fever. I did check my LO's mouth and it looks like he may have thrush. So yesterday it was back to the pumping board. I am starting to feel like this BF thing is never going to happen and I am getting so exhausted pumping all the time

[@llli*carm3]

You've worked so hard to get to this point, mama...don't give up yet! I can imagine that you're feeling pretty exhausted though

Are you doing anything to treat the thrush? Both you and baby need to be treated. Check out Dr. Newman's Candida Protocol http://www.breastfeedinginc.ca/conte...agename=doc-CP and Dr. Jay Gordon's Thrush page http://drjaygordon.com/breastfeeding/thrush.html If you're having deep breast pain though, you might actually need to see your doctor to get some oral diflucan. I think you might want to get checked out anyway, because I'm not sure that thrush would cause a fever.

I can't remember from your other posts, but have you seen a lactation consultant to check out your baby's latch?

[@llli*iritita]

I go to the Dr today. Because I have an HMO, I have to get a referral for a LC. I will hopefully be seeing one next week. I have been waiting a long time for this and can't wait!! Thanks for the links, I will check them out.

[@llli*carm3]

If you think that your symptoms do match the descriptions, print out some of the info and bring it with you to your appointment, if you can. A lot of docs aren't necessarily knowledgeable about treating nipple/breast thrush (in my experience and from what I've read anyway), and it's good to have some reference material. For example, a one-off dose of oral diflucan isn't enough to treat a breast candida infection, although it usually does the trick for a vaginal one. So you'd need your doctor to prescribe a longer course.

That really sucks about the referral to the LC. Is there a LLL meeting in your area in the meantime?

[@llli*andie613]

So sorry to hear about the problems! I too had sore, cracked nipples my first weeks of breastfeeding--has baby been checked for a tongue-tie? That was my LO's problem. We took him to a pediatrician who specializes in correcting this and had it clipped (a quick process). This did lots to give him a better latch and allow for some nipple healing.

What you describe sounds like thrush with the possibility of also having mastitis . I had both my first few weeks. The radiating pain during/after feeds sounds like thrush, and the fever could be mastitis. With mastitis, you would probably also notice that one or both breasts would be red, either a reddish area on one part of the breast or it might look like the whole bottom of the breast was dipped in a red/pink dye; it would also be quite sensitive to the touch. You could also be having some body aches, especially along the spine, and it might feel like the flu. All of the symptoms were present when I had it. When you go to the Dr, have him/her do a breastmilk culture (express a few drops on to a swab) so they can tell if you have a bacterial infection. I had staph, which required a certain kind of antibiotic to get rid of it (clindamycin).

Unfortunately, taking antibiotics will not help with the thrush. What my Dr and LC recommended was 14 days of fluconazole (Diflucan) at 200 mg a day, the first day taking a double dose. In combo with this, I also treated the nipples with gentian violet, an old school yeast remedy recommended by Dr. Newman, available over the counter at most pharmacies. To use: paint nipples with it before bedtime, then nurse baby (it will treat baby too! seems more effective than nystatin that most pediatricians give babies). Your nipples, babies mouth, and anything that comes into contact with either will be stained purple. Baby will look like a clown. Wear old clothes for you and baby. I wore disposable nursing pads which I changed after EVERY feeding (do not reuse, as this will help breed more yeast or grow bacteria, especially if you leak a lot). If purple does stain clothes/sheets/etc, soak in rubbing alcohol and scrub; I was mostly successful in getting stains out. Dr N's recommendation was to use gentian violet for 3-7 days. I used it for 5. Also, I used all-purpose nipple ointment, which has to be prescribed by a Dr and compounded at the pharmacy, but very very helpful for healing cracks and preventing further infection (contains antibacterial and anti yeast properties). I applied after every feeding; no need to wipe off before feeding unless you really glob it on. A 30 mg tube lasted me about 4 months (it's quite expensive if your insurance won't cover it, as mine didn't, but definitely worth the money). If you can't get APNO, you can mix a fairly good substitute yourself: 1/2 part polysporin (not neosporin), 1/2 miconazole or lotrimin, and you can add hydrocortizone cream/ointment, as the steroid component will help healing.

Good luck--you can do it. I've been there, done that, and it is annoying, painful, and seemed hopeless at the time. But perserverance and commitment to breastfeeding helped me make it through the dark times. You seem very committed, and I think you can push through it! Keep us posted!

[@llli*lllmeg]

Sorry to hear about this!

Just speaking generally, mothers do not have to wait for a referral. Mothers can choose to see a private IBCLC and pay out of pocket, assuming there is a private IBCLC in your area. Insurance paying anything for lactation consultants is a very new development and the kinks are going to take a very long time to work out, if they ever are. So I seriously urge mothers to consider all their options in such cases, as not being able to see an IBCLC in a timely manner when there are serious issues may be a very big problem.

Cracked and bleeding nipples indicate a poor latch, not thrush. Not saying thrush is not part of the picture. But what you describe sounds like poor latch to me.

Your baby needs to learn to latch properly, which may take some practice, and if there is a physical barrier to this happening, it has to be fixed.

What about, instead of jumping right in and nursing all day next time, you ease into it by combining pumping with nursing for a few days, while being really careful with latch?

[@llli*iritita]

Thanks for the support ladies!!! I am going to try to nurse at least once a day so that we can work on our latch issues. I went to the DR today and she diagnosed me with Mastitis, so I will be taking some antiobiotics for it (this fever is kicking my butt!!). My Dr did recommend a LC that I will be calling today to set up an appointment. I am just so ready to nurse exclusively!! Wish me luck!!

[@llli*andie613]

If you are taking a course of antibiotics, you will definitely want to look out for signs of thrush (you mentioned in your original post that you thought baby had thrush in the mouth. Did you confirm this? Maybe see a pediatrician asap.) Check out this article: http://kellymom.com/bf/concerns/chil...enting-thrush/. You can also check kellymom.com for articles on getting a better latch and signs/treatment of thrush for yourself. Your LC should be able to diagnose thrush in you and baby based on observation and your description of pain (pain for mastitis should decrease in about 2 days of antibiotic treatment. If still present after that, then likely you have yeast too).

Also, I'd still ask the LC about checking to see if baby has a tongue tie. You never mentioned why you began EPing the first 5 weeks.

[@llli*iritita]

I struggled with sore, cracked, and bleeding nipples. I pumped to let them heal. I did ask the dr about thrush but she said that thrush is not something to worry about and it should go away on its own. oh doctors!!!

[@llli*carm3]

Wow, I can't believe your doc said that thrush is nothing to worry about and will go away on it's own. I beg to differ!

You might want to get a second opinion on that, if you can...

I would recommend starting a probiotic if you're on antibiotics.