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Thread: split spot on areola keeping me from nursing!

  1. #1
    Join Date
    Nov 2011
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    Default split spot on areola keeping me from nursing!

    I have a 19 month old. I've had a split open spot on one areola that is causing severe pain. I think it was orignally caused by her teeth weeks ago, her biting down on me after she fell asleep and I've nursed with it for weeks even with the pain but it has gotten so bad that it is unbearable now, and wider and deeper as time has gone on. It's about a quarter of an inch long across the top of the areola, and deep enough to look scary to me, but although it looks deep it has only bled once, most of the time just looks wet inside, I can see my flesh that you shouldn't be able to see and yet it is not bleeding. I think her teeth are going in that spot. I didn't nurse for a period of 24 hours hoping that it would heal enough to be bearable, and it did start to look better but when she nursed last night it opened it back up and it's worse than ever, I couldn't stand the pain. I pumped during the 24 hr. period and the pumping does not hurt. This time I am going to go 2 days before I let her try again. When she's not nursing I have been keeping lanolin on it with a band-aid to hold the lanolin on it plus the band-aid keeps my bra or shirt from rubbing it. I'm concerned about how deep it is and what I should do. I don't want to stop nursing, I am hoping to nurse to age 2 and beyond if possible, so this is really worrying me. In the beginning I had severe pain which nipple shields got us through and we've been off of those since she was 4 months old - and I know the nipple shield would be the answer to this, but now she will not nurse using the nipple shield, I've tried coaxing her to do it and she just won't. I've considered going to the dr. but would rather not if I can take care of it myself. Does anyone have experience with this? If I went to the dr. what would they do? - this may should drastic but would they consider stitching it so she could nurse? I think I could bear the pain even with stitches if her teeth couldn't go in the spot or her sucking didn't open it up or whatever is happening. I'm worried about my supply by going for periods without her nursing because I don't seem to be able to get much out by pumping so I'm afraid I will stop producing on that side. And, for her nutrition, she is a heavy heavy nurser, many times a day and half the night, a light eater of solid food, although she does eat of course but hasn't seemed to eat any more solid food during the periods of only nursing on one breast. She has always turned down cow's milk, makes a face immediately when she gets some in her mouth and won't touch it again after she realizes what is in the cup and also will not drink my pumped milk, not crazy about anything to drink other than nursing. So, l could really use some advice about any of this. What did anyone do about a split like this?

  2. #2
    Join Date
    May 2006
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    21,266

    Default Re: split spot on areola keeping me from nursing!

    If it were me, I think I would wean temporarily from that side. Rely on the pump to maintain supply and solids and sippy cups to fill any holes in your LO's diet- she's old enough now that she'll probably be able to pick up her solid intake to compensate for any lack of milk.

    If you decide to continue to nurse on that side, I would try very hard to vary your LO's nursing position so that her teeth fall in some other spot.

    It certainly can't hurt to see the doctor, and ask for a medical opinion on the wound and on what to do about it. But don't be too surprised if the advice you get is "Just wean her" or something similarly unhelpful. I kind of doubt they'd stitch such a small tear, especially because the baby seems very likely to reopen it. But they can certainly check to see if it's infected, and can prescribe something to use on it if it is. And infection is likely, IMO. I would start using something like APNO on the crack, rather than lanolin. When I had bad cracks, my LC recommended using a combination of 1% hydrocortisone cream and bacitracin antibiotic ointment (pea-sized amount, mixed and applied using a clean finger). The hydrocortisone is for inlflammation, the antibiotic is for infection.
    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
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    Nov 2011
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    Default Re: split spot on areola keeping me from nursing!

    Thank you mommal. I am on my second day this time of having her off that side and it is closed up and looks better. I really dread testing it but may do so tonight or I may wait for another day if I chicken out. After I read your post I started used polysporin on it last night for overnight which has bacitracin in it, thank you for that advice because that hadn't occurred to me yet, I just had nipple=lanolin in my head. As for the position I never found one that would work because she has 4 teeth across the top and the split is, I had said 1/4 inch, I think it's actually a little longer than that, maybe 1/3 in. horizontally across the top of the aeola so her teeth get in it no matter what I did. The only thing I can think of is literally upside down which I what I think I will try when I nurse again, with her top teeth on the bottom of my nipple if I can manage that. Probably lying down.
    This pain is so severe and feels exactly like what I went through the first month of nursing, although I had no split spots then, but the similiarity in feeling makes me wonder if something like this was going on under the skin before with no visible injury on the outside, back then. I never could explain back then how bad the pain was and it lasted for months and seemed very unusual. It's also weird to me how deep this split, which looks just like a cut, is, maybe a quarter inch deep, and yet no bleeding (just once it did), just wet flesh you can see. I know it's gross to even describe it, and to see it is gross too. If you had a cut on your finger or somewhere for example, this deep, it would be bleeding like crazy. I think this may have been going on under the skin during my first few months. It makes me want to learn more about how the nipple and areola are made. Mostly though I just want rid of this problem so we can nurse pain free. Thank you for your input.

  4. #4
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    Default Re: split spot on areola keeping me from nursing!

    One more thing. I have tried putting my just pumped breast milk in the nipple shield to coax her to try it. I've tried just offering her the breast with the nipple shield when I know she's hungry, and she is adamant that she will not touch it. funny because for 4 months in the beginning when the pain was extremely severe the shield was the only way we could nurse and we wouldn't be nursing how if not for it, and she nursed like a champ with it then and I had a hard time convincing her to switch to the real nipple! Now I'm having the opposite problem The shield works like magic for pain so if I could convince her to do it I could stop pumping and really nurse that side because the shield would protect the split spot. Does anyone have any experience or advice about convincing an older baby to use a shield? Any trick that could be used?

  5. #5
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    Default Re: split spot on areola keeping me from nursing!

    I know it can be really weird to have this horrible gash that isn't bleeding- BTDT! But I think that with a persistent wound, you shouldn't expect it to be bleeding all the time. The blood vessels that get severed when the wound first occurs quickly seal themselves off with clots and there's healing going on inside the wound even if it is being reinjured every day. If you had a cut on your finger that kept on being opened up, multiple times a day, it wouldn't bleed, either.
    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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    Nov 2011
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    Default Re: split spot on areola keeping me from nursing!

    Thank you for the support. I am going on my 5th day now resting that side, although pumping several times a day. The pumping doesn't open up the gash, but I do notice that there is blood along the slit now, even though it is closed. I never saw blood when I was letting her nurse. She cried horribly and got so angry about not being allowed to nurse that side at first and now she has stopped fussing about it. She will raised up that side of my shirt and shake her own head "no". It's covered with band-aids too which in addition to caring for the gash keeps her from latching onto it suddenly when I'm not looking or I'm asleep. My question today is how long would you go before risking her nursing again? How long would you give it to heal enough that it's resistant and stronger so hopefully wouldn't be opened up again? I plan to do the upside down nursing when I try again but I'm afraid of the pain, very afriad, it was terrible, but even more afraid of the risk that when I try and if she opens it up again I'm right back where I started which would be so frustrating.

  7. #7
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    Default Re: split spot on areola keeping me from nursing!

    I think the blood is to be expected. Now that the gash is able to close, the blood vessels should be re-establishing their pathways through that area. But they're still fragile and not fully re-formed, so they're going to break rather easily. Ergo: bleeding when you pump.

    I wish I knew how many days to give an injury like this. But healing rates differ so much from person to person. I think you just have to judge for yourself when that side is feeling good enough to use.

    Good luck! It sounds like you and your LO have handled this really well so far!
    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!"

  8. #8
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    Nov 2011
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    Default Re: split spot on areola keeping me from nursing!

    I went 9 days without letting her nurse that side, then started by letting her nurse upside down so that her top teeth were on the bottom. That didn't work because her top teeth then bit into that area. Nothing compared to the problem I had previously on the top, not even in the same ballpark, it's more like the skin is just scraped off this time but is still quite painful. I started just doing the cradle hold again and am still nursing with the pain, using lanolin on the new bad spot between nursing. I just hope it doesn't worsen over time like it did on the original spot until I have another cracked open place. The originial gash has healed over but is red and looks weird, sort of translucent over the healed area which to me looks like it could crack open again at any time, it's like I'm holding my breath every time I nurse that side. I never expected to have this problem at 19 months and am so frustrated by it. If the pain gets worse rather than better I will concentrate again on coaxing her to use the nipple shield but that has been completely unsuccessful so far, she won't touch it. I've only tried breast milk in it to get her to use it but if this gets worse I am going to try something that I normally wouldn't give my baby, like ice cream inside the shield or maybe juice. I am very frustrated by this pain, it's been a couple of months now I think since the first spot started hurting. Those teeth I suppose are getting longer in front, but the one breast is fine, her teeth are not hurting it even though there have been a couple of instances of her biting down painfully, there hasn't been any lasting pain.

  9. #9
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    Default Re: split spot on areola keeping me from nursing!

    It's so odd that you have the problem on just one side. Do you think there's an underlying infection? Something that's making the skin on that side more vulnerable to damage?

    It's wonderful that you were able to get this to heal. And that you're trying all these different positioning tricks. I know it can't be easy, and I really admire your persistance!
    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!"

  10. #10
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    Nov 2011
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    Default Re: split spot on areola keeping me from nursing!

    Thank you, and about the infection I don't see any signs of infection, but I wonder if there could be something that just doesn't have any symptoms. BUT - - this side has been different from the beginning so I think there is just something different about it. I remember describing to an lc how it was shaped differently (over the phone) in the first few weeks. I started out with inverted nipples and they became a different shape as I began nursing. In the beginning the two looked different and this one hurt more, although both hurt. She couldn't seem to latch onto this one at all, couldn't get a grip on it and just pinched the tip of the nipple with her gums. But now, I can't see much of a difference between the shapes although the areola part is smaller on the trouble side. Another thing that was always different is that the trouble side used to leak constantly, I used to say that the stop valve didn't seem to work. For the first few months at least there was milk dribbling out that side. The other side leaked some too but the trouble side always had milk running out.
    I think what has happened is that the injury I got originally just won't heal because of the need to keep nursing, even though I gave it a 9 day rest. There is an open spot on the top again now and the bottom, though neither compares in look or pain to the original gash, and I am still nursing and have one position that is working fairly well by not having her teeth in any sore spot, it's to cradle hold her, but having the rest of her body out to the side on a pillow rather than in my lap. I don't know if there is a name for that, but if I have her head completely horizontal I'm ok for now and keeping my fingers crossed. Still not nursing that side at night though because I'm too lazy to sit up like that, but doing it right before we lie down and first thing in the morning, but having her nurse on the good side at night, which is pretty often, and the bad side ends up full in the morning. I hope that alone is not compromising supply.
    thanks again for the input. Do you know if there could be an infection that would have no outward noticeable symptoms?

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