When to call it quits

[@llli*madchen66]

I have been battling breastfeeding since my son was born 3 months ago. I cannot seem to get ahead of my problems and I just don't know how much longer I fight everything. I have had mastitis 3 times and it just knocks me down so bad that I have to have my mom come and help because I'm not sure I can care for my son when I'm so sick. I believe I have thrush but my Dr disagrees, and my son's pediatrician won't treat him either because he has no signs of thrush. I have gashes on both nipples that have taken weeks to heal. I had a visible yeast overgrowth on my right nipple about a month ago, and my Dr prescribed nystatin. It seemed to help the wound heal on that side, and the yeast is gone. I haven't nursed from the right side since the onset of the yeast overgrowth, just pumping that side. This has created an over supply problem on the left side, which I am guessing causes the mastitis to occur. I also have thrush symptoms on the left side (burning after feeding, stabbing pain, red nipples) and that has made day to day life pretty miserable. I've been doing everything I've read about fighting thrush, but again, my Dr and my son's pediatrician don't believe that thrush is the problem so i don't know how to get ahead of the thrush. I know this is long winded... I just don't know what the breaking point is because I feel like I am not as good of a mother as I can be with these problems constantly dragging me down physically and emotionally. I have set a goal of breastfeeding until 6 months but I can't imagine continuing to live like this for 3 more months. At what point do the benefits of breastfeeding outweigh my sanity and physical pain?

[@llli*mommal]

At what point do the benefits of breastfeeding outweigh my sanity and physical pain?

This is such a difficult question because the answer is different for every mama-baby pair. There's no equation that can correctly balance the benefits of breastfeeding, the risks of formula, and the happiness of the mom.

A lot of people say that you get "all" the benefits of breastfeeding if you do it for 2 weeks. Or 6 weeks. Or 3 months, or a year, or 2 years. The truth is that the is no point at which breastfeeding maxes out its beneficial effects. The longer you nurse, the better it is for the baby's health and the better it is for your health. But you also don't have to feel that stopping breastfeeding is a tragedy, if you truly feel that you are done. You've made it to 3 months and that's terrific!

It sounds like you've never had a good rapport with your doctors over the pain you're experiencing. Have you seen a LC, preferably an IBCLC? Is switching doctors a possibility for you?

And can you tell us more about what you're experiencing? Large gashes make me think that there's a latch problem, in addition to or perhaps instead of thrush. And latch issues usually get better with time, as the baby grows! I know because I was in similar shoes 7 years ago, with my first baby- I had severe pain, large gashes on my nipples, and I really wasn't sure I could continue to nurse. But at around 5 months everything changed- my nipples healed, and breastfeeding actually became enjoyable, and I went on to nurse that baby until age 3. I've never regretted it, even though I swear that I thought it would drive me absolutely nuts when I was going through it.

[@llli*madchen66]

We have seen a lactation consultant a couple times and she says his latch is good. My OB says that based on how my nipple looks, he is sucking on the nipple instead of the areola. My Dr thinks my pain is caused by the open gashes, not thrush. I suppose that's possible but I wish I could get the gash to heal so I could test that theory! I've noticed two or three little blisters on my nipple as of a few days ago, so I'm not sure what that is... My son really seems to take comfort in nursing and the thought of quitting makes me so sad. I've been telling myself that a few months of misery for me is worth him having a good start, but geez it is so hard to go day to day (feeding to feeding) while still trying to be a good mom to my son.

[@llli*andie613]

So sorry to hear, mama! I had lots of problems with nipple cracks, blisters, and pain, so I can relate. I agree with PP that you should seek additional medical advice from a different Dr or IBCLC LC if possible. If not: can you get your Dr to prescribe All Purpose Nipple Ointment (per Dr Jack Newman)? It's relatively harmless and has an antibiotic/antiyeast component that will definitely help with your wounds and prevent further bacterial infection and possible mastitis. I used this for 7 months on one crack, nursing all the while, no need to wipe off before hand. If you are certain it's yeast, which can prevent cracks from healing, there is an OTC remedy that worked great for me called gentian violet. Most pharmacies should have it. Here is instructions written by Dr. Newman on how to use it: http://www.breastfeedingmums.com/dr_...ian_violet.htm. I did the treatment for 5 days and the yeast was gone. Definitely don't go for more than 7 days--you probably would want to try for maybe 3, then see if things improve over the next week. You will still be sore, and the cracks will take time to heal, so don't expect immediate results in terms of healing wounds. As for the blisters, I had those too, and I think it was just poor latch--seems like baby's tongue or mouth was rubbing the nipple weird. The blisters cleared up on their own, and using the APNO definitely helped when they would pop on their own.

Good luck mama! Just know it gets better. Time will help heal.

[@llli*mommal]

Has baby been checked really carefully for tongue tie? Misshapen nipples (wedged, creased, ridged, shaped like new lipsticks) are usually traceable to exactly what your doc said- baby is sucking on the delicate nipple rather than the resilient areola. It's often a problem with very young babies, because a tiny mouth can't take a deep "bite" of breast and that results in the nipple sitting too shallow in the baby's mouth. But when a mom with an older baby continues to have cracks and pain, I have to wonder if a tongue tie might not be part of the puzzle.

One avenue you could consider would be to pump one side for a few days and nurse on the other, and see if healing starts to take place. If it does, then latch issues become a more likely explanation for the cracks and pain.

[@llli*andie613]

I agree with PP about tongue-tie. My LO had that and it led to some nasty cracks and major pain! It was easily corrected with a little clip. Nursing was much better after that!

[@llli*madchen66]

We did have his tongue looked at and Dr said it was normal. I am scared to use gentian violet because I've read that it produces carcinogens... don't know if this is true? I will try the All purpose cream- hope the Dr will write the prescription. I don't like any part of formula feeding but I seriously don't think I can function normally with this constant pain! I am supposed to go back to work next week and besides not being able to wear a shirt, I am afraid of more mastitis from pumping/not being able to get away to do it when I need to. I know I sound like I'm whining (and I guess I am) but I had such high hopes for breastfeeding and it has been the exact opposite of what I thought it would be. I guess part of my frustration is the death of that idea of easy feeding and bonding with my son.

[@llli*mommal]

When you pump, does that feel better than nursing or about the same?

Please don't worry about "whining"- it's really okay to not like breastfeeding and to feel let down by the experience, and you shouldn't have to keep those feelings in! Especially not here, where so many women know exactly how hard it can be to nurse through pain and illness and disappointment. When my firstborn was little, I remember thinking to myself "This is natural, it should be easy!" but then I realized that natural doesn't necessarily = easy. Childbirth is natural, and that's not easy. Running long distances, climbing mountains, learning to swim- all natural, and not easy.

Breastfeeding often gets marketed as a way to bond with your baby. And it does help you bond- just not always as advertised! I know that I pictured before my first was born was this beautiful, relaxing, loving experience. And what I got was horrendous pain, a relationship with the pump that I didn't want, bottles, screaming... But my LO and I still emerged with an unshakable bond. Sometimes breastfeeding does proceed in that rosy glow of love and cuddles- and sometimes it's more like you and your baby are going through a war together.

[@llli*lllmeg]

As far as when to call it quits, of course that is up to you. I will suggest this-in my exp with mothers who want to breastfeed but have struggles-

those who get good help, and feel they had tried everything they can, are able to stop trying (if/when that is their choice) with less regret and certainly no guilt. They are proud of what they have done and know in their hearts it is time to try a different route.

Mothers who, looking back later, felt they ‘gave up’ too easily have regret and sometimes guilt feelings.

Mothers who do NOT get good assistance from (or are actively undermined) by their hcps often feel angry about their experience, but this anger is often directed toward themselves (and sometimes toward breastfeeding advocates) rather than the hcps who were unable or unwilling to help them.

We have seen a lactation consultant a couple times and she says his latch is good.

ok, I just want to make sure you saw an IBCLC and the appointments were similar to what is described here. http://cwgenna.com/lconsult.html

If this is not what your appt was like, you have not really seen an IBCLC, in the sense, there was not time nor actions to do what is needed to make a clinical assessment and give you a plan of action. If it IS what it was like, and the only suggestion you got was 'latch looks good" maybe it is time to see someone else.

If you have thrush, it has to be treated in both you and baby. Otherwise it will recur. Sometimes even with appropriate treatment it will recur, and mom has to consider what may be causing the recurrence and what she can do about it-is a diet change in order? could her partner also require treatment? Does she need to re-sterilized pump parts, bottles etc? IF the problem is thrush, it IS treatable. But if you cannot get treatment no matter what you do, then ?

I think it is time to consider the possibility that you are not getting proper treatment for a curable issue, which may cause you to have to stop breastfeeding. This is not your fault. Not being able to nurse your baby is a health issue for both you and your baby, so it is possible you are both being seriously failed here by your hcps. I think it may be time to start being angry that you cannot get needed medical treatment and stop blaming yourself for a situation that is not of your making.

Dr. Jack Newman has a complete protocol for thrush online. Your IBCLC SHOULD be able to walk you through various options.

Gentian violet has been used safely for generations of mothers and babies for the treatment of thrush. It is important it is diluted the proper amount or it can cause sores in baby’s mouth.

The prescription med that has been proven to be most effective on thrush is Diflucan, (Flucanazole) NOT Nystatin. It can be prescribed for both mother and baby.

I keep saying 'if' about the thrush as there are other issues that can cause nipple wounds and pain. Bacterial infection, for example-again you can talk to your IBCLC about that, as well as a poor latch/tt.

Many doctors are unaware of the 'newer' thinking on tt, it's various forms, and it's detrimental effect on breastfeeding. Have you researched this possibility for yourself at all? you can find info at www.kiddsteeth.com

possible nipple healing suggestion: http://cwgenna.com/nhygiene.html

kellymom.com has a good article on recurrent mastitis and its causes.

[@llli*madchen66]

Thank you for all the input and information. It definitely gives me some things to try. Also (hoping to get a little more help...) as of a couple days ago my son has started pulling away while still latched about 10 minutes into a feeding an. I don't hear him swallowing in the couple minutes leading up to this. I've tried detaching him and relatching but he does the same thing over and over. I then pull him off and start burping him, and he cries like he's still hungry. If I manually express at this time, milk comes out. I gave him expressed milk bottles for three feedings yesterday because he was fussy ande I was worried he wasn't getting enough to eat. I pumped for each feeding missed and ONLY GOT 1.5 OZ EACH Time! I usually get 3-5 oz when I pump so this really freaks me out, plus he ate 16 oz total of the freezer supply and I am panicking that I can't pump enough to replace that fast enough. I have to go back to work in a couple days so I won't be able to nurse more frequently. Am I seeing a decrease in supply for some reason or am I just being dramatic??