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Thread: 8 Week Old - Thrush/Still Having Pain - Totally Discouraged

  1. #11
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    Okay, symmetrical is great! It means that whatever is off about the latch, it's probably not so bad and the baby will probably grow out of the problem. But the fact that you saw your nip turn white after nursing is really suggestive of vasospasm. Have you tried slapping a hot water bottle on the nipple right after nursing?
    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!"

  2. #12
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    Jun 2014
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    OK that is reassuring. I should have also mentioned though - sometimes she makes a smacking sound - particularly when I'm very engorged and milk is flowing everywhere. I always un-latch and re-latch her when this happens, but it never goes away. Is this a big issue? Perhaps contributing to my pain?

    And I haven't tried a hot water bottle - I'm usually in such a rush to rinse with vinegar and apply APNO that I'm rushing off to the bathroom after she's finished - but I will try that on our next feed and see if it helps.

  3. #13
    Join Date
    Jun 2009
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    How often are you engorged and milk is flowing everywhere? Fast letdown may cause baby to clamp, which of course would also be painful and possibly lead to vasospasm.

    Baby is young, but not all that young. I am a little concerned that even after working with breastfeeding helpers, latch is still so difficult that baby must be readjusted so often. I am also a little concerned if there is regular engorgement at 8 weeks. Do you have overproduction do you think? Or is baby maybe not nursing with enough frequency to prevent engorgement? Being engorged also makes it harder for a baby to latch, and that can again can cause latch pain.

    Has your LC ever tried to help you with latch or positioning ideas? Like mommal says just because latch looks ok does not mean it is ok. Pain indicates a not-quite there latch. Even if thrush is part of the problem, improving babies latch should help make nursing at least a little less painful.

    This article has a nice overview of different ideas for improving latch and positioning (finding the 'right' position for you and baby often helps baby latch better) http://feedthebabyllc.com/latch-and-positioning/

    Is there any actual nipple injury- fissures, cracks, etc? I think these would indicate a possible bacterial infection. I am unclear if it is possible without that.

  4. #14
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    Jun 2014
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    Hi Meg -

    I am usually only engorged at night. In the past few days, baby has been sleeping 6-7 hours at night, which is twice as long as we usually go between feedings. So when we wake up, I'm engorged. When that happens, I can tell I definitely have fast letdown. What I do, per the suggestion of my LLL leader, is express some milk into a washcloth first to drain the breast and make it easier for baby to latch.

    Both my LLL leader and LC have encouraged me to use the laid back nursing position, which I've tried many, many times with limited success. I've tried it lying in various spots (bed, couch, recliner etc) and I still experience the pain. I've also tried football, cradle (instead of cross cradle) and having baby "sit up" on my lap. Position doesn't seem to affect the pain very much, unfortunately … but maybe I am doing something wrong.

    I had several cracks that bled in the first week, but those have been healed for quite some time - I do not notice any cracks or fissures now - just the pink nipple and pink ring around the nipple on the areola.

    We have an appointment with our LC Friday and I'm praying she can help us - I am getting more and more discouraged by the day. I don't want to quit breastfeeding, but it is so hard being in pain so much - I really thought we would have hit our stride by 8.5 weeks.

  5. #15
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    Jun 2009
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    I am usually only engorged at night. In the past few days, baby has been sleeping 6-7 hours at night, which is twice as long as we usually go between feedings. So when we wake up, I'm engorged. When that happens, I can tell I definitely have fast letdown. What I do, per the suggestion of my LLL leader, is express some milk into a washcloth first to drain the breast and make it easier for baby to latch.
    OK so that is probably not a big deal.

    I am really sorry-I was getting the obviously incorrect impression that you were not getting help with latch.
    Were you shown the breast sandwich latch, discussed asymmetric latch, other latch ideas?
    Position doesn't seem to affect the pain very much, unfortunately … but maybe I am doing something wrong.
    I think that with positioning and latch there is no wrong-there is just what is right for YOU. Right means it does not hurt and baby is getting milk. Nothing else really matters. All the tips for positioning and latching baby are suggested ways to try to get to that. You use what works and forget about the rest. Sometimes what does not work at one point works later, and vice versa.

    "Laid back" positioning really only means mom is reclined. It can mean mom is very slightly reclined. What is comfortable for mom is the key. Usually but not always, it also means baby is on mom with baby's front to mom, with baby resting on mom's body, so gravity is holding baby to mom, rather than pulling baby away, off the nipple. But baby can be in any position, approaching the breast from any direction.

    You have struggled a long time, and it must feel very unfair. Unfortunately, it does sometimes happen that the cause of latch pain & consequently, what to do about it, is very elusive.

    So here are some thoughts you might consider researching and/or discussing when you meet with your IBCLC. I am not suggesting these are appropriate in your situation, but these are some different ideas that I know of that have helped in difficult latch pain situations. You may have tried some already. There are of course drawbacks to some to be considered.

    For thrush:
    Diflucan in a larger dose maybe?
    Diflucan for baby?- (Diflucan has been shown much more effective for thrush than Nystatin)
    Taking a rest from any topical treatment in case something is exacerbating the issue.
    APNO
    Gentian violet
    Grapefruit Seed Extract.
    Examining if/how re-occurrence might be happening


    Other things to consider:
    The possibility this is a bacterial infection or some other skin condition
    Reynauds Phenomenon
    Baby's anatomy-tongue or lip tie, palate issues?
    Might a nipple shield help?
    Taking a "rest" from any nursing, pumping instead, feeding baby your pumped milk, and seeing if that helps nipples heal.
    Last edited by @llli*lllmeg; June 25th, 2014 at 08:29 PM. Reason: can't spell. Or think half the time.

  6. #16
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    Jun 2014
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    Hi Meg -

    Thanks so much for all of this information and your detailed response. Things have unfortunately taken a turn for the worst - last night I was awakened by the most horrible pain I have yet experienced in 8 weeks, in my right nipple. I have no idea what is going on - if the thrush has now gotten worse (could it attack me that quickly all of a sudden?) or moved into my ducts - or perhaps this is vasospasm pain. I would describe it as extreme burning and the feeling of shards of glass in the nipple. The pain has lessened a little bit and I just did a feeding on the breast, trying to fight through the pain but I'm not sure I'll be able to do that all day. I think I am going to pump and try and give my breasts a break.

    I am truly hoping our LC can help me tomorrow - test us, officially for thrush/bacterial infection so we can find out once and for all if that's what we're dealing with - and if not, move on to explore other possibilities.

    Right now, I'm just trying to make it through the day … thanks again so much for your help.

  7. #17
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    Besides the breast pain, how are you feeling?
    Sudden onset of (more) severe pain sounds more like a plug or bleb and/or mastitis to me. Were you starting to get engorged again when this occurred? Was baby nursing when the pain came on?

    If you have to pump for a while, pumping regularly with a good, effective pump can allow your milk supply to remain good so you can live to fight another day, so to speak. Also you could pump on one side and nurse the other, pump some of the time nurse some of the time etc. depending on your needs. Just be sure pumping is comfortable and not causing more damage.

    I am not sure if there is an actual test for thrush, although I have heard of dermatologists "diagnosing" thrush.
    My understanding is there is a way to test for staph infection of the nipple, but I doubt an IBCLC can run the test. I am getting my info about bacterial infection from Breastfeeding Answers Made Simple, 2010, page 651. The section it is in is called "Bacterial, Fungal and Viral Nipple Infections." within chapter 17 "Nipple Pain and Other Issues" Your IBCLC almost surely has this book, perhaps you can go through this section together.

  8. #18
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    Jun 2014
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    OK quick update here - would love to know what you all think!

    Today we saw both the pediatrician (who is also a certified LC) and OBGYN today. Collectively they decided that since we've all been on thrush meds for over 3 weeks now with little improvement, that we should try something new and see what happens. So all of us are going off all meds - no more Nystatin for LO, no more Diflucan or anti-fungal cream for me. Instead, I'm just putting a little bit of lanolin on my nipples as well as a new prescription steroid cream but only twice a day, not after every feeding.

    I am also working on setting up an appointment with another, independent certified LC next week to have our latch evaluated again, but someone different, just to make sure it is good.

    Thoughts on this new direction?

  9. #19
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    Jun 2009
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    It's more important what you think, but here are my thoughts-I often think that if something is not responding to appropriate treatment, than that is a good sign that that is not the issue. So this sounds reasonable to me. I was thinking that the sudden pain sounded either like what I suggested in pp or perhaps a reaction to all the topical treatment.
    I also think it is a good idea to get a fresh pair of eyes on an issue. With two of my kids, 1 and 3, I had pretty severe early on latch issues, and in both cases saw two different IBCLC's. In both situations, seeking the second opinion was actually suggested by the first IBCLCs I saw each time, who were different IBCLCs. Purely by coincidence, the IBCLC I saw the second time with baby 3 was the same IBCLC I saw the first time with baby number 1.

  10. #20
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    Jun 2014
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    Default Re: 8 Week Old - Thrush/Still Having Pain - Totally Discoura

    Thanks so much for all of your help and support Meg - I truly appreciate it. I am really hoping that we see some improvement - and its encouraging to know that you got a second opinion from a couple different LC's too … I figured, at this point, why not.

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