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Thread: Need serious help and support: pain, vasospasm

  1. #1
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    Default Need serious help and support: pain, vasospasm

    I've been having terrible pain, vasospasm, cracking, and discoloration (pink, red, purple) in nipples for weeks now. My 9-week old son has only had BM up to now but I am beginning to think I can't do it anymore! At 4 weeks I was in such excruciating pain - after a local LLL leader, my pediatrician, and my doula all said our latch looked fine - that we saw an IBCLC, who immediately diagnosed a lip tie. A pediatric dentist lasered both his lip and tongue tie 4 weeks ago and we diligently did his stretches following. Despite this I continued to be in pain and so our IBCLC finally suggested a nipple shield. I've been using nipple cream regularly, trying to apply dry heat, as well as take B complex and magnesium/calcium for vasospasm. The shield helps - I still have pain and blanching - but LO is not transferring enough and trending downward in percentile growth. I've used some donor milk as we try to get through it and am exclusively pumping now as LO gets more this way (otherwise falls asleep at breast and then cries out of dissatisfaction and hunger and doesn't sleep well). We followed up on lasering his tongue/lip ties with both craniosacral and chiropractic. Nothing helps. Now IBCLC says his mouth just needs to grow more to accommodate more breast tissue to help with latch. I'm getting desperate and to the end of my rope as we've tried EVERYTHING. I spend my entire day on the couch holding him, hoping he sleeps for 30min to give me time to pump, and feeding him what I've pumped (still pumping every 2hrs thru the night). I'm utterly exhausted.

    Please help.

  2. #2
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    Default Re: Need serious help and support: pain, vasospasm

    Hi, it sounds like you have had a really frustrating time of it. I have a few questions.

    Are you sure nipple shield fit correctly and was put on correctly?
    How long have you been exclusively pumping?
    What kind of pump?
    How does pumping feel? Is it comfortable? Are you healing now that you are exclusively pumping?
    What is your typical per ounce output when you pump? Daily?
    How many ounces is baby eating daily?
    Why are you pumping every two hours overnight...in order to get in a certain number of pump sessions each day? And how many is that?
    Have you and LC discussed Reynauds and possible treatment? Thrush? Bacterial infection on the nipple?
    Overall how has growth particularly, weight gain been? What do you mean by baby "trending downward" ?

    Here is what I am thinking. Exclusive pumping for the time being, because there is simply no way to get a comfortable latch no matter what you have tried, and you are consequently being repeatedly injured- That makes sense to me, although of courser if makes me wonder what is going on that latch is still so injurious to you.

    But exclusive pumping because baby falls asleep at the breast, sleeps short stretches, cries, wakes hungry, and is trending downward in percentile growth is less certain. Because all of that could be entirely normal. In fact is all sounds entirely normal except for actual slow weight gain, but I am not sure if that is happening or not? It is normal for a baby to shift around on the growth percentiles.

    If you are confident in your LC then please ignore the following, but I have to say I am also not one to buy the whole "Baby has to grow more" idea. If we were talking a nine day old, maybe. Or a very premature or very tiny baby. But not a normal sized 2 month old- It just does not make sense to me. I have seen some very tiny babies nurse entirely comfortably on a very large breast. Do you have a particular anatomy that would cause a shallow latch- like a very large, long, or thick nipple?

    Generally speaking, babies learn to nurse by nursing. So it is generally helpful to keep baby nursing at least a few times a day while working on latch issues...

    If the nipple shield helped with the pain and you were/are able to heal while using it, or, once you are healed, what about using the shield to nurse as much as makes sense, pumping as needed to protect your production (which is at possible risk when using a shield) and supplementing with the milk you pump...would that make any sense do you think?

    Also, what if you tried nursing/pumping more often in your waking hours so you can put together a longer stretch of sleep at night? Getting just 4-6 hours may help a great deal.

    What help do you have? Relatives, friends? If no one, what about someone you might pay to come over a few hours a week so you can nap?

    If you cannot nurse baby and cannot pump enough for baby, then supplements are required. If donor milk is not available, then that means formula. If this is what is needed, it is ok. The benefits of both breastmilk and nursing at the breast are dose-related. In other words, more is better than some and some is better than none.
    Last edited by @llli*maddieb; December 17th, 2015 at 09:13 PM.

  3. #3
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    Default Re: Need serious help and support: pain, vasospasm

    Quote Originally Posted by @llli*maddieb View Post
    Hi, it sounds like you have had a really frustrating time of it. I have a few questions.

    Are you sure nipple shield fit correctly and was put on correctly?
    Per my IBCLC, the 20mm I am using is the best fit. She considered 16, but we've looked at the 20 over several weeks now and there is space when I put it on and the nipple is able to be pulled to the tip, but not through the shield.

    How long have you been exclusively pumping?
    An update: I am now almost exclusively using the shield to nurse on-demand and pumping a few times a day to get extra. My supply seemed to be suffering from EPing and I was also going utterly crazy, sleep-deprived pumping every 2 hours for 1/2 an hour when he might only sleep 45 minutes. But I had been EPing for probably a week or so.

    What kind of pump?
    Medela PIS

    How does pumping feel? Is it comfortable? Are you healing now that you are exclusively pumping?
    When I was EPing, yes, I felt that there was some healing and pumping became more and more comfortable. I've recently tried latching him without the shield, and the pain/vasospasm was almost immediate, so pumping is not as comfortable now.

    What is your typical per ounce output when you pump? Daily?
    Per pumping session, I usually pump anywhere from between 1.5oz - 4.5/5 oz. I have to say I've not counted over a day.

    How many ounces is baby eating daily?
    When I was EPing, he would eat everything I could pump and sometimes still seemed to want more (though I wondered about overfeeding by bottle??).

    Why are you pumping every two hours overnight...in order to get in a certain number of pump sessions each day? And how many is that?
    Pumping every 2 hrs was the recommendation of a doula-friend to increase/maintain supply. I thought I should in order to make sure there was enough milk.

    Have you and LC discussed Reynauds and possible treatment? Thrush? Bacterial infection on the nipple?
    She has raised the issue of Reynauds but said that the only treatment is a heart medication which is a pretty heavy duty thing. She does not think it is thrush and I don't see any white patches (me or him). We've not discussed bacterial infection.

    Overall how has growth particularly, weight gain been? What do you mean by baby "trending downward" ?
    By trending downward, the ped means that according to the WHO growth charts (which go by breastfeeding, not formula feeding as the U.S. charts do), he is declining, percentile wise. For all measurements (head circ, weight, height, weight by height, etc.). However, he is gaining weight. Since I have switched back to nursing with the shield (which still hurts! a LOT!), it appears he is gaining the recommended .5oz-1oz daily.

    Here is what I am thinking. Exclusive pumping for the time being, because there is simply no way to get a comfortable latch no matter what you have tried, and you are consequently being repeatedly injured- That makes sense to me, although of courser if makes me wonder what is going on that latch is still so injurious to you.
    I did continue to EP as long as I could but eventually it felt that my supply began to suffer (body responds better to baby than to pump). The dentist saw him the other day and said that his upper lip-tie did reattach, but we gained about 3-4mm of space (meaning it no longer attaches to the very bottom ridge of his gum, but 3-4mm above that). From what I can see, he opens wide but seems not to maintain a big open mouth when actually latching. I try to follow the "trick" my IBCLC uses of flipping his lips after he latches but this either seems not to work well, or he cannot maintain it (he seems to when she does it though - I guess I'm just not good at it). I can hear him swallowing so I KNOW he is getting milk, though sometimes it takes 8-10 sucks before he will swallow (other times, there are fewer sucks per swallow)

    But exclusive pumping because baby falls asleep at the breast, sleeps short stretches, cries, wakes hungry, and is trending downward in percentile growth is less certain. Because all of that could be entirely normal. In fact is all sounds entirely normal except for actual slow weight gain, but I am not sure if that is happening or not? It is normal for a baby to shift around on the growth percentiles.

    If you are confident in your LC then please ignore the following, but I have to say I am also not one to buy the whole "Baby has to grow more" idea. If we were talking a nine day old, maybe. Or a very premature or very tiny baby. But not a normal sized 2 month old- It just does not make sense to me. I have seen some very tiny babies nurse entirely comfortably on a very large breast. Do you have a particular anatomy that would cause a shallow latch- like a very large, long, or thick nipple?
    I don't have any particular anatomical anomalies that would seem to be the cause of the problem. Was a cup size D pre-pregnancy, DDD during pregnancy, probably back to a C-D now. Have not been told I have problematic nipples (just very sore-looking ones). They have never bled, however.

    Generally speaking, babies learn to nurse by nursing. So it is generally helpful to keep baby nursing at least a few times a day while working on latch issues...
    Yes, now I am almost exclusively nursing with the shield since supply seemed to suffer just EPing. I tried nursing without shield a couple times over the last two days, and feel just as sore as at the beginning when he was born. The pain is almost instant and pretty terrible. I also get creased over the top of the nipple - which I know is usually related to latch. I latch and re-latch as much as I can without driving myself, and him, insane, but it doesn't seem to help. Position changes don't seem to help. I think I am doing the "breast sandwich" correctly but that doesn't seem to help either. Hence the possible "small mouth that needs to grow??"

    If the nipple shield helped with the pain and you were/are able to heal while using it, or, once you are healed, what about using the shield to nurse as much as makes sense, pumping as needed to protect your production (which is at possible risk when using a shield) and supplementing with the milk you pump...would that make any sense do you think?

    Also, what if you tried nursing/pumping more often in your waking hours so you can put together a longer stretch of sleep at night? Getting just 4-6 hours may help a great deal.
    I am trying to do more day-time pumps rather than night. I'm nervous about my supply suffering, however, especially since I'm now so close to the 12-week "established supply" mark. Early on it seemed impossible to pump because he would feed and then not be satisfied enough for me to get out all my pumping equipment and pump.


    What help do you have? Relatives, friends? If no one, what about someone you might pay to come over a few hours a week so you can nap?
    I do have some help and have been asking as much as I can.

    If you cannot nurse baby and cannot pump enough for baby, then supplements are required. If donor milk is not available, then that means formula. If this is what is needed, it is ok. The benefits of both breastmilk and nursing at the breast are dose-related. In other words, more is better than some and some is better than none.
    I did get some donor milk and have used it sporadically as I've felt he needed it.
    Last edited by @llli*lllkaren; December 27th, 2015 at 11:36 AM. Reason: Added quote tags for readability

  4. #4
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    Default Re: Need serious help and support: pain, vasospasm

    Ok great. How are things going now? Any changes?

  5. #5
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    Default Re: Need serious help and support: pain, vasospasm

    I'm sorry, first time using forum and getting used to the format. I answered all your questions but they appeared as part of the quote of your message. I've copied/pasted below.

    Are you sure nipple shield fit correctly and was put on correctly?
    -Per my IBCLC, the 20mm I am using is the best fit. She considered 16, but we've looked at the 20 over several weeks now and there is space when I put it on and the nipple is able to be pulled to the tip, but not through the shield.

    How long have you been exclusively pumping?
    -An update: I am now almost exclusively using the shield to nurse on-demand and pumping a few times a day to get extra. My supply seemed to be suffering from EPing and I was also going utterly crazy, sleep-deprived pumping every 2 hours for 1/2 an hour when he might only sleep 45 minutes. But I had been EPing for probably a week or so.

    What kind of pump?
    -Medela PIS

    How does pumping feel? Is it comfortable? Are you healing now that you are exclusively pumping?
    -When I was EPing, yes, I felt that there was some healing and pumping became more and more comfortable. I've recently tried latching him without the shield, and the pain/vasospasm was almost immediate, so pumping is not as comfortable now.

    What is your typical per ounce output when you pump? Daily?
    -Per pumping session, I usually pump anywhere from between 1.5oz - 4.5/5 oz. I have to say I've not counted over a day.

    How many ounces is baby eating daily?
    -When I was EPing, he would eat everything I could pump and sometimes still seemed to want more (though I wondered about overfeeding by bottle??).

    Why are you pumping every two hours overnight...in order to get in a certain number of pump sessions each day? And how many is that?
    -Pumping every 2 hrs was the recommendation of a doula-friend to increase/maintain supply. I thought I should in order to make sure there was enough milk.

    Have you and LC discussed Reynauds and possible treatment? Thrush? Bacterial infection on the nipple?
    -She has raised the issue of Reynauds but said that the only treatment is a heart medication which is a pretty heavy duty thing. She does not think it is thrush and I don't see any white patches (me or him). We've not discussed bacterial infection.

    Overall how has growth particularly, weight gain been? What do you mean by baby "trending downward" ?
    -He is gaining (8 lbs at birth, 10'12" by 2 months). By trending downward, the ped means that according to the WHO growth charts (which go by breastfeeding, not formula feeding as the U.S. charts do), he is declining, percentile wise. For all measurements (head circ, weight, height, weight by height, etc.). However, he is gaining weight. Since I have switched back to nursing with the shield (which still hurts! a LOT!), it appears he is gaining the recommended .5oz-1oz daily.

    Here is what I am thinking. Exclusive pumping for the time being, because there is simply no way to get a comfortable latch no matter what you have tried, and you are consequently being repeatedly injured- That makes sense to me, although of courser if makes me wonder what is going on that latch is still so injurious to you.
    -I did continue to EP as long as I could but eventually it felt that my supply began to suffer (body responds better to baby than to pump). The dentist saw him the other day and said that his upper lip-tie did reattach, but we gained about 3-4mm of space (meaning it no longer attaches to the very bottom ridge of his gum, but 3-4mm above that). From what I can see, he opens wide but seems not to maintain a big open mouth when actually latching. I try to follow the "trick" my IBCLC uses of flipping his lips after he latches but this either seems not to work well, or he cannot maintain it (he seems to when she does it though - I guess I'm just not good at it). I can hear him swallowing so I KNOW he is getting milk, though sometimes it takes 8-10 sucks before he will swallow (other times, there are fewer sucks per swallow)

    But exclusive pumping because baby falls asleep at the breast, sleeps short stretches, cries, wakes hungry, and is trending downward in percentile growth is less certain. Because all of that could be entirely normal. In fact is all sounds entirely normal except for actual slow weight gain, but I am not sure if that is happening or not? It is normal for a baby to shift around on the growth percentiles.

    If you are confident in your LC then please ignore the following, but I have to say I am also not one to buy the whole "Baby has to grow more" idea. If we were talking a nine day old, maybe. Or a very premature or very tiny baby. But not a normal sized 2 month old- It just does not make sense to me. I have seen some very tiny babies nurse entirely comfortably on a very large breast. Do you have a particular anatomy that would cause a shallow latch- like a very large, long, or thick nipple?
    -I don't have any particular anatomical anomalies that would seem to be the cause of the problem. Was a cup size D pre-pregnancy, DDD during pregnancy, probably back to a C-D now. Have not been told I have problematic nipples (just very sore-looking ones). They have never bled, however.

    Generally speaking, babies learn to nurse by nursing. So it is generally helpful to keep baby nursing at least a few times a day while working on latch issues...
    -Yes, now I am almost exclusively nursing with the shield since supply seemed to suffer just EPing. I tried nursing without shield a couple times over the last two days, and feel just as sore as at the beginning when he was born. The pain is almost instant and pretty terrible. I also get creased over the top of the nipple - which I know is usually related to latch. I latch and re-latch as much as I can without driving myself, and him, insane, but it doesn't seem to help. Position changes don't seem to help. I think I am doing the "breast sandwich" correctly but that doesn't seem to help either. Hence the possible "small mouth that needs to grow??"

    If the nipple shield helped with the pain and you were/are able to heal while using it, or, once you are healed, what about using the shield to nurse as much as makes sense, pumping as needed to protect your production (which is at possible risk when using a shield) and supplementing with the milk you pump...would that make any sense do you think?

    Also, what if you tried nursing/pumping more often in your waking hours so you can put together a longer stretch of sleep at night? Getting just 4-6 hours may help a great deal.
    -I am trying to do more day-time pumps rather than night. I'm nervous about my supply suffering, however, especially since I'm now so close to the 12-week "established supply" mark. Early on it seemed impossible to pump because he would feed and then not be satisfied enough for me to get out all my pumping equipment and pump.

    What help do you have? Relatives, friends? If no one, what about someone you might pay to come over a few hours a week so you can nap?
    -I do have some help and have been asking as much as I can. For the most part folks are busy during the day and I often cannot "get ahead" of him enough in bottles of pumped milk to have it available for someone to give him.

  6. #6
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    Default Re: Need serious help and support: pain, vasospasm

    There are 2 treatments for Raynaud's: a drug called Nifedipine, which you don't want to take unless you have to, and heat. Try keeping a hot water bottle or heating pad nearby and slap it on the nipple- well, don't "slap" it but you know what I mean!- as soon as you finish nursing.

  7. #7
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    Default Re: Need serious help and support: pain, vasospasm

    Quote Originally Posted by @llli*mommal View Post
    There are 2 treatments for Raynaud's: a drug called Nifedipine, which you don't want to take unless you have to, and heat. Try keeping a hot water bottle or heating pad nearby and slap it on the nipple- well, don't "slap" it but you know what I mean!- as soon as you finish nursing.
    Is the heat a temporary solution, or is it actually supposed to help the nipple stop blanching/burning eventually? I was applying dry heat for several days but it didn't seem to do anything more than just help in the moment, so I gave up.

  8. #8
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    Default Re: Need serious help and support: pain, vasospasm

    Heat is a temporary solution. But so what? You are looking to feel better. You don't want to not treat the symptoms just because you can't find a permanent fix.

  9. #9
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    Default Re: Need serious help and support: pain, vasospasm

    Hi I am sorry I did not see your detailed response. Ok, so, if baby is mostly nursing, even with a shield, this sounds like good improvement in the overall situation, but of course it is not good at all that you continue to be in pain. I have to say that personally I would be researching the medication option more if Raynauds is a real possibility. To be in nursing pain two months down the line is a pretty heavy duty problem, and may require a heavy duty solution.

    As far as warmth, what have you tried for keeping your entire body warmer overall, all the time? This may help. And I agree with mommal, why wouldn't you want the temporary relief? Also I am not sure the heat needs to always be dry heat...Does it? I agree with mommal about hot water bottle or heating pad but would it sometimes be easier to be able to put a clean cloth warmed quickly in some hot water and would that help? Not sure.

    Also, improving latch will usually help improve nipple pain, even if thrush and vasospasm are also in the mix. Did the dentist think that baby needed another snip? I take it not, but what do you think?

    As far as baby opening mouth wide prior to latching, and then not latching well or not maintaining a good latch, here are some ideas. I know you have tried these, but I am going to revisit the ideas with you if you will bear with me.

    Laid back position where baby is more on top of you, and you are leaning back. This may take lots of practice and playing around to find the way that works for you. Also, if you are injured, especially if you are badly bruised, then even if you get the latch better, nursing may still hurt while that heals, but there should be at least some improvement pretty quick.

    Many nursing positions- even sidelying- result in gravity pulling baby away from mom, and this can pull baby "off" the nipple and into a shallow, clampy latch, where baby is holding on by clamping the nipple. (This can also happen if the milk flow is fast and baby is trying to slow it down. ) Those are two of the many reasons many moms adopt a "laid back" nursing positions(s). This is called biological nurturing by Suzanne Colson, http://www.biologicalnurturing.com/ who did the original research supporting this positioning. Nancy Morhbacher describes a similar technique she calls "Natural Breastfeeding" on her blog here: http://www.nancymohrbacher.com/blog?...+Breastfeeding

    I have been helping moms use this position style for years, as well as using it myself, and IMO the key is to not get hung up on "doing it" some particular way. Pictures of other moms and babies will only take you so far. You and baby will need to find what works best for you. The basics are very simple- mom is leaning back, a little or a lot, and baby has their front turned into and touching mom's body. Typically baby's "whole front," even legs and feet and arms and hands, in some contact with mom. But not always.

    Since it is not helping, instead of flanging baby's lips out with your fingers, have you tried pushing more of your breast into baby's mouth, or gently repositioning baby so baby "self adjusts" their latch while nursing? Have you tried bringing baby to the breast from different angles to see it this helps? (sometimes the angle that works best for one breast is not the one that works best for the other.) The breast is round, and a baby can consequently be positioned to approach the breast from any direction. At the very least, this may give you a chance to not keep nursing directly over a place where the nipple and/or areola is bruised and tender. Laid back positioning helps facilitate these changes in latch direction.

    Breast sandwich - This can be tricky and it is important that 1) you are compressing the breast in the right direction. This changes depending on how baby is approaching the breast and 2) It is important to be sure that your hand/fingers are not blocking baby's mouth. Many moms compress the breast in a c hold or u hold( depending on what direction they are compressing the breast) with the thumb on one side (or on top) and the 4 fingers on the other side (or underneath.) - this is fine, but because they do not see their fingers well, their fingers edge too close to the nipple, blocking baby from getting that deeper latch. You may find that you cannot fit all 4 fingers actually on the breast and instead want to splay them out against your ribs or between your breasts, with one or two working with the thumb in shaping the breast. When I needed to remember how to position my hand, I remembered that I wanted my thumb to "line up" - be on the same side of my breast- as baby's nose, and my fingers in the side where baby's chin was. Another way to think of it is that if baby is in a cradle or cross cradle and thus approaching the breast from the side, you want to use a U shaped hold to compress the breast, and if baby is coming to the breast from underneath the breast, as with a football hold, and also as with some laid back positions where baby is coming from below (or above) the breast, you would use a C hold. Personally I found using the C hold much more effective in getting my breast compressed enough to do the trick, so I always positioned baby in a foot ball hold or, when doing laid back, coming at the breast from below - underneath- the nipple.

    Of course I understand it is hard to do breast shaping with a shield on. While it is frustrating, it can be done with some finagling. When I used a shield, the key was getting that thing on the breast really securely and deep enough. Some moms keep them on better using a little lanolin like a glue. As far as shield size, yes you certainly do not want the end of the nipple to be pulled through the holes in the shield (Ouch, and yes I have seen this happen.) But on the other hand, ideally you do want the nipple to be pulled into the tip a ways as soon as you put the shield on. A too large shield may cause some nipple rubbing against the sides of the shield reservoir, also a too large shield can actually cause baby to not be able to latch on as far as baby otherwise would be able to because the tip is pushing too far into baby's mouth. It has been a while since I bought a shield, but I believe they are fairly inexpensive. It might be worth it to buy one of the smaller size just to try it. Also, different brands are shaped slightly differently. Something to think about.

    You have been using one so long I assume you have this down, but just to be sure, you can see this info on putting a shield on. http://kellymom.com/ages/newborn/nb-...s/wean-shield/

    Without seeing actual numbers on those weight checks, I cannot comment on gain. It is normal for a baby to move about on the charts, even the WHO charts. If a baby is being weighed frequently (more than every several weeks) it is also common to see gain rate fluctuate week to week or day to day, so I would suggest look at overall gain from baby's lowest known weight (not birth weight) until the last weight check (unless those were on two different scales, in which case look at the two weight checks furthest apart but on the same scale.) What you would generally hope to see in the first 3 or 4 months of life is overall average gain of about 6-8 ounces a week or more. The WHO charts are the most accurate charts of course, but that does not mean all babies grow along some precise curve...Those nice steady curves you see on a growth chart are the averages of hundreds of healthy, gaining babies, not a reflection of what is normal gain progression for any one individual baby. For an excellent explanation about growth charts and why they are so often misinterpreted. I suggest the book My Child Won't Eat (A wonderful book in any case.)

    Your pump output per session sounds quite good- 1.5 to about 3 ounces per session is average, 4-5 ounces is quite a lot, so if you were ever getting that it does not sound like there was an issue with production. However, without knowing overall output it is hard to say. I am curious how much baby was eating daily during the time you were pumping and bottle feeding and gain slowed-- But if all is going fine with gain now, no need to run over old ground.
    Last edited by @llli*maddieb; December 26th, 2015 at 12:52 PM.

  10. #10
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    Default Re: Need serious help and support: pain, vasospasm

    . I have to say that personally I would be researching the medication option more if Raynauds is a real possibility.
    Agreed! Because if this is Raynaud's and not a vasospasm caused by compression, then it's a lifelong issue. Not a severe one- the worst that really happens is that you get that intense pain in the affected extremity. But it does correlate with other medical issues, particularly autoimmune diseases, and you want to keep an eye on that, and make sure your doctor knows it's part of your history.

    As far as warmth, what have you tried for keeping your entire body warmer overall, all the time? This may help. And I agree with mommal, why wouldn't you want the temporary relief? Also I am not sure the heat needs to always be dry heat...Does it? I agree with mommal about hot water bottle or heating pad but would it sometimes be easier to be able to put a clean cloth warmed quickly in some hot water and would that help? Not sure.
    Stay warmer overall- vests, socks, and slippers are your friends- and don't worry about "dry" heat. Wet heat works just as well. People with Raynaud's are always running their affected extremities under hot water or jumping in the shower.

    ETA: I went back and looked at your original post and I'm thinking that what you are experiencing might equally well be explained by thrush or a bacterial infection. I know your LC dismissed the possibility, but it sounds like she did so because the baby didn't have white patches in his mouth. Well, that's not a deal-breaker. It's quite common for one member of the nursing pair to be asymptomatic, though both are infected. What would you say to trying some APNO? If there is a fungal or bacterial component here, that might help. Even a modest improvement after starting APNO would be a clue that maybe you need to do something more aggressive about the thrush/bacteria possibility.
    Last edited by @llli*mommal; December 27th, 2015 at 06:24 AM.

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