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Thread: Nipple Sensitivity. What's normal?

  1. #1

    Default Nipple Sensitivity. What's normal?

    My son just turned 5 weeks on Friday and we've been breastfeeding from the start. I had some cracks on my nipples but it's fully healed on the left and almost on the right. Feeding sessions are not painful anymore, so I suppose latch must be ok. But I do feel pain in between feedings. Not all the time, but most times.
    It's pretty bad, for example, when I get out of the shower or if there is other sudden temperature change, like the AC starts running or I open the freezer. Having clothes or a towel brush against them hurts too. It's not unbearable pain... but bad enough that it bothers me and I take painkillers to deal with it.


    Is it normal to feel like this? Everything I read seems to constantly point to thrush or bad latch. But like I said before, I think the latch is ok but I do still try to pay extra attention each time we nurse, just in case. As for thrush, I guess it could be but I do not see any white spots on either me or in baby's mouth. And I do not think the pain is inside the breast, but it can admittedly be hard to tell.

    Anyone have any idea?

  2. #2
    Join Date
    May 2006
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    21,259

    Default Re: Nipple Sensitivity. What's normal?

    The pain escalating in response to a sudden temperature pain could point to vasospasm: http://kellymom.com/bf/concerns/moth...ple-blanching/. Vasospasms can co-occur with either thrush or latch problems or both, so this can be a difficult puzzle to tease apart.

    Can you describe the pain a bit more? And do you have any other symptoms of or predisposing factors for thrush? These would be things like:
    - Recent antibiotic use, including for GBS at the time of birth or as part of postoperative care for a c-section
    - Vaginal yeast infection in mom, diaper yeast rash in baby
    - Multiple small, slitlike cracks in the nipple skin
    - Nipples appearing more red, pink, shiny, or flaky than usual, or dry-looking skin in the nipple/areola
    - Pain which can be described as burning or itching
    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

    Default Re: Nipple Sensitivity. What's normal?

    The pain is hard to describe and the closest I can compare it to is a friction burn like a rug burn. I suppose describing it as "burning and itching" is not too far off.
    It is worse if I am topless and pretty much unbearable if I wear any loose clothing that can brush against the nipples. It's most tolerable if I wear a bra.


    The nipples are more pink than the areola but not flaky or shiny or dry looking. There are not several slitlike cracks in the nipple skin but one tiny crack at the base of each nipple. I just noticed that yesterday, as these tiny cracks are kinda on the underside of the nipple so not very visible unless you really dig around. Besides those there is the big crack on the right which is mending, I think, but still pretty ugly looking.

    No antibiotic use. No vaginal yeast (as far as I know) or diaper rash.


    Thanks for your reply!

  4. #4
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    Default Re: Nipple Sensitivity. What's normal?

    Okay, based on the friction burn/itching/burning feeling, the extreme sensitivity to touch, and the tiny crack at the base of the nipple, my best guess is that this is either thrush or bacterial, probably complicated by vasospasm and a now-resolving latch issue. I'd look into getting treatment for yourself and the baby for yeast (thrush) and also for bacteria. Using APNO would be a good way to start: http://www.nbci.ca/index.php?option=...apno&Itemid=17. It has an antibiotic, an antifungal, and a corticosteroid, so it's good for infection and inflammation.
    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!"

  5. #5

    Default Re: Nipple Sensitivity. What's normal?

    Can I get APNO from any doctor or how does that work? That website kinda makes it sound like it's not a product manufactured by regular pharmaceutical companies...? Sounds a little sketchy, to be honest. But I'm willing to try anything, lol.

    I'm also trying to figure out if the pain is caused by vasospasm restricting blood flow, or by baby clamping down on the nipple and restricting blood flow.

    I keep reading that if the baby clamps down on the nipple, it comes out misshapen (like a lipstick? Wtf. I don't even own a single lipstick, so what a bad comparison, harhar!) but I honestly have no idea what to look for.
    My nipples are tiny normally and after nursing they are big and weird looking. But they are also big and weird looking the few times I've used the handheld pump...

  6. #6
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    Default Re: Nipple Sensitivity. What's normal?

    You can get APNO from a compounding pharmacy. It's really not sketchy- that link comes from Adar. Jack Newman, who is an internationally regarded breastfeeding expert and pediatrician. If your doc is unfamiliar with it, you might want to write to Dr. Newman- I have heard that he is very responsive.

    If you experienced vasospasms before getting pregnant or breastfeeding, then the vasospasms are independent of nursing, though nursing may be exacerbating them. If you never had a vasospasm before getting pregnant or nursing, then the vasospasms are probably related to breastfeeding and to compression by the baby- though thrush can also contribute to vasospasms! (See, I told you this was tricky to tease apart... )

    When a baby is latching on too shallow, the nipple will likely emerge from the baby's mouth with a noticeable ridge or crease across the tip, and will have a flattened surface below the crease. It looks a lot like a brand-new lipstick- here's a decent pic: http://www.musingsofamuse.com/2012/1...ring-2013.html

    If your nipples are basically symmetrical after nursing- like a pencil eraser- then this probably isn't a shallow latch problem. At least, not primarily.
    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!"

  7. #7
    Join Date
    Nov 2012
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    Default Re: Nipple Sensitivity. What's normal?

    What you describe sounds a lot like my experience with thrush. Especially the part about the pain when topless vs. when wearing a bra. I had some good success with diluted grapefruit seed extract applied to my nipples several times a day, and swabbed inside my LO's mouth with a q-tip. If you do have thrush, it's important to treat your baby too, even if he doesn't have visible signs of thrush. Otherwise you can pass it back and forth. I also experienced a lot of vasospasms secondary to thrush - I found that using a sock filled with rice and warmed up in the microwave helped a lot. In my case, I did end up needing a couple weeks of oral diflucan, and that cleared up the thrush. The vasospasms hung around for another few weeks but weren't as painful, and they eventually went away.

  8. #8

    Default Re: Nipple Sensitivity. What's normal?

    Thank you very much. I'm going to call the doctor tomorrow and see what they can do.
    I really appreciate being pointed in the direction of vasospasm as just learning about it and how heat can help is already providing some relief

  9. #9

    Default Re: Nipple Sensitivity. What's normal?

    Btw, if I get APNO for me, what do I use to treat my son for trush?

  10. #10
    Join Date
    Nov 2012
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    Ontario
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    Default Re: Nipple Sensitivity. What's normal?

    I think that depends on the doctor. I know that both Dr. Newman and Dr. Jay Gordon don't recommend nystatin (it's got sugar in it, which feeds the yeast). Does your son have white patches at all? Personally, I just used the diluted grapefruit seed extract in my baby's mouth, but she didn't have any white patches. I believe they can prescribe diflucan for babies, but it's something you'd have to talk to your doc about.

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