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Thread: Healing a really stubborn crack

  1. #1
    Join Date
    Jan 2014
    Location
    Minnesota
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    240

    Default Healing a really stubborn crack

    My daughter is 2 weeks old and I have had a crack in the side of the left nipple ever since my milk came in around day 4. My doula was a lactation consultant and came last week, we decided baby's latch and position are fine, but I have a heavy let down on that side so she is pinching the nipple which is keeping the crack from healing. I use a nipple shield on that side and have been treating it religiously with breast milk, Mother Love nipple cream, and also used a soothie for a few days but it doesn't seem to be healing. I am trying to decide if it is time to start pumping that side? Or any other suggestions? I don't think it is infected and nursing isn't intolerably painful as long as I use the shield.

  2. #2
    Join Date
    Mar 2012
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    West Salem, Ohio
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    176

    Default Re: Healing a really stubborn crack

    I would suggest letting it air dry after showers, maybe after nursing, sometimes the fresh air will help it heal. Also for the heavy let down, I used to unlatch DD3 let it spray and then latch her back on. I've heard that laid back nursing can also help with that. I personally wouldn't use the nipple shield every time. When I used one I tried to only use it a couple times a day. I would look into a medicated cream, one that might help heal it faster. I'm not sure of which ones are safe so definitely check before using one. Pumping doesn't get the milk out like a nursing baby does, I would personally worry about getting a clogged duct, or mastitis.

    Good luck and I hope you get more advise/opinions
    Mother of 3 beautiful girls, and expecting baby number 4 in July

    Elisabeth ~ 9/25/07
    Eliana ~ 1/08/09
    Elivia ~ 1/22/12 ~ EBF

    with all 3 still

  3. #3
    Join Date
    May 2006
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    21,259

    Default Re: Healing a really stubborn crack

    As long as you can bear to nurse on the crack, do it. If you need to use the shield to make it bearable, use it when necessary. As the PP said, pumping doesn't get the milk out the way the baby does, so it's always best to nurse, if you can. Having an open crack does increase your risk of infection, but that doesn't mean you're likely to get an infection. I never did, and I had horrible open cracks for 4.5 months (Don't worry- that is NOT a typical experience! Most moms do not have cracks for anywhere near that long.).

    Self-care for cracks:
    - My LC recommended a combination of 1% hydrocortisone cream and Bacitracin antibiotic ointment on cracks (use a pea-sized amount, mixed and applied using a clean finger). She said it didn't need to be washed off before nursing.
    - Hydrate the crack before nursing by immersing the nipple in a shot glass of warm water or giving it a good soak with a wet washcloth. Softened scabs tear open less painfully than dry ones.
    - Time!!! Cracks that are a product of latch issues go away as the baby grows bigger, stronger, and more adept.
    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!"

  4. #4
    Join Date
    Jan 2014
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    Minnesota
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    Default Re: Healing a really stubborn crack

    I should mention this crack never scabs over - it is just an open slit all the time.

  5. #5
    Join Date
    May 2006
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    Default Re: Healing a really stubborn crack

    Where is the crack? At the tip or just on the underside of the tip of the nipple? Or is it at the base of the nipple,where areola and nipple meet? Somewhere else?

    Does it gape wider after nursing? Or does it typically have a slit-like appearance?

    When the baby comes off the breast, what does the nipple look like- is it symmetrical, like a pencil eraser, or asymmetrical/wedged/creased/ridged/shaped like a new lipstick?
    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
    Jan 2014
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    Minnesota
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    Default Re: Healing a really stubborn crack

    It is at the base by the areola. It looks like a slit or a dent. I always use the shield on that side but n the other side the nipple will come out looking pretty round unless I pop her off on purpose when the latch feels wrong. The right nipple is fine so I don't think it is her latch. The left boob is bigger and has a heavier let down so she pinches that side more. I have started nursing twice on the right for every once on the left to try to slow down the supply on the left.

  7. #7
    Join Date
    May 2006
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    Default Re: Healing a really stubborn crack

    Yeah, I agree: based on the position and appearance of the crack, it sounds more like something infectious than a latch issue. The usual suspects would be either bacteria or yeast (thrush). Can you go see the LC again, or see a different LC, preferably one who is an IBCLC? I'd also stop by the pediatrician's office and have him/her look at the baby- if this is thrush, it may show up in baby's mouth or diaper area.

    Are any of the following part of your story right now:
    - vaginal yeast infection?
    - recent course of antibiotics, including antibiotics for GBS+ given at the time of birth?
    - nipples/areolas appearing more red or pink than usual?
    - flaking or dry-looking skin in the nipple or areola area?
    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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    Jan 2014
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    Minnesota
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    Default Re: Healing a really stubborn crack

    None of the above. I'm sure it isn't thrush. I don't see any other signs of infection either.

  9. #9
    Join Date
    May 2006
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    21,259

    Default Re: Healing a really stubborn crack

    Okay. But I still think it's a good idea to see the LC, and to keep an eye out for the symptoms listed above. The slit-like crack at the base of the nipple sounds very much like a thrush/bacteria issue to me!
    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
    Join Date
    Jan 2014
    Location
    Minnesota
    Posts
    240

    Default Re: Healing a really stubborn crack

    I am going to try some saline rinses and antibiotic ointment for a couple days to see if that helps. I would go see a LC but the wind chill at this moment is -26 . Thanks for the suggestions, I will probably go in if this doesn't heal by the end of the week.

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