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Thread: Need serious help and support: pain, vasospasm

  1. #11
    Join Date
    Dec 2015
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    Default Re: Need serious help and support: pain, vasospasm

    Quote Originally Posted by @llli*mommal View Post
    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.



    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.
    I wouldn't be opposed to trying APNO (I assume Jack Newman's All Purpose Nipple Ointment?). Is that something I can get myself or do I need a prescription, and can my midwife prescribe it?

    My gut says that I do not have Raynaud's though I am certainly open to exploring it. I've never been told I have it before. I guess I always considered myself a "cold person" in that my feet tend to be a little chilly, but I've never had burning/stinging in other extremeties, or blanching or anything like that. The nipple blanching only came up after weeks of trying breastfeeding.

    Update: still going with the shield and occasionally trying without (though I'm terrified to do it). Usually I get the ridge, or line, horizontally across the tip of the nipple within a minute or so. I'm trying, trying to stuff as much breast tissue in there as I can and flange his lips out but it still feels pinchy. Next weekend will be 3 months of this ...

  2. #12

    Default Re: Need serious help and support: pain, vasospasm

    Quote Originally Posted by @llli*livingtemple View Post
    Update: still going with the shield and occasionally trying without (though I'm terrified to do it). Usually I get the ridge, or line, horizontally across the tip of the nipple within a minute or so. I'm trying, trying to stuff as much breast tissue in there as I can and flange his lips out but it still feels pinchy. Next weekend will be 3 months of this ...
    This answers the question I was just about to ask!

    So when the nipple comes out of your baby's mouth, you're consistently seeing a ridge on it?

    Normally, when a baby is nursing well, the nipple is kind of stretched out when it comes out of baby's mouth, but it's cylindrical like a pencil eraser. If the nipple is flattened, lipstick-shaped, ridged, or creased, it's a sign the issue is likely a latch or suck problem.

    Have you tried the "laid back" nursing position that maddieb was talking about? Sometimes that can help babies get a deeper latch. Here's a video that demonstrates it:


  3. #13
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    May 2006
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    Default Re: Need serious help and support: pain, vasospasm

    I wouldn't be opposed to trying APNO (I assume Jack Newman's All Purpose Nipple Ointment?). Is that something I can get myself or do I need a prescription, and can my midwife prescribe it?
    I believe you need a prescription, and your midwife should be able to write one. I think- and hopefully some one will correct me if I am wrong- the basic ingredients are an antibacterial agent, an antifungal, and something like hydrocortisone to deal with inflammation.

    My gut says that I do not have Raynaud's though I am certainly open to exploring it. I've never been told I have it before. I guess I always considered myself a "cold person" in that my feet tend to be a little chilly, but I've never had burning/stinging in other extremeties, or blanching or anything like that. The nipple blanching only came up after weeks of trying breastfeeding.
    I agree with LLLKaren- the flattened, "ridged" appearance to the nipple certainly suggests a latch issue, and compression can easily cause a vasospasm. Vaspasms caused by Raynaud's feel identical to those caused by compression. But on the off chance that what you are experiencing is caused by Raynaud's rather than compression, here are some "fun" facts about Raynaud's:
    - symptoms can wax and wane over time, though they are generally worse during cold weather
    - symptoms are not necessarily visible if you don't know what you are looking for

  4. #14
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    Dec 2015
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    Default Re: Need serious help and support: pain, vasospasm

    Quote Originally Posted by @llli*mommal View Post
    I believe you need a prescription, and your midwife should be able to write one. I think- and hopefully some one will correct me if I am wrong- the basic ingredients are an antibacterial agent, an antifungal, and something like hydrocortisone to deal with inflammation.



    I agree with LLLKaren- the flattened, "ridged" appearance to the nipple certainly suggests a latch issue, and compression can easily cause a vasospasm. Vaspasms caused by Raynaud's feel identical to those caused by compression. But on the off chance that what you are experiencing is caused by Raynaud's rather than compression, here are some "fun" facts about Raynaud's:
    - symptoms can wax and wane over time, though they are generally worse during cold weather
    - symptoms are not necessarily visible if you don't know what you are looking for
    The other day I *thought* I had one pain-free latch without the shield - first time in almost 3 months. Did this with laid-back breastfeeding. Successive attempts, however, are proving incredibly painful. Getting a ridge on the top of the nipple. Now LO is also becoming incredibly squirmy and shaking head back and forth like my breast is a dog toy and this is not helping matters. I'm wondering if we need to get his upper lip re-lasered. We had a follow-up with the dentist last week and she said it did re-attach, but at about 3-4mm above the ridge of the gum (whereas when he first went in, the tie went all the way down to the ridge). Her professional opinion was that we did not NEED to get it done, but could if we wanted.

    It seems the ridge suggests that what's going on is latch-related, rather than infection. I trust my IBCLC implicitly - she came highly recommended by my very experienced doula with over 10 years of experience - and have seen her something like 3-4 times now. I have no idea what to do and can't believe things have been going on this long. I weighed LO pre- and post-nursing today (painfully, without the shield), and he gained 3 oz. He rarely seems "milk-drunk" after a nursing session, however, so I have no idea if he's satisfied. He usually is happy enough to play afterwards and is not crying.

    I really appreciate the continued help. Not sure I'm going to make it over here.

  5. #15
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    Jun 2009
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    Default Re: Need serious help and support: pain, vasospasm

    3 ounces indicates good milk transfer. Milk drunk is such a misleading idea. Only one of my 3 babies ever seemed 'milk drunk' even though I had more than enough milk with all three. And the one who looked milk drunk was not even my fastest gainer.

    If laid back helped ever, I would suggest keep trying it. There is not any one single way to "do" this position, it can be fiddled with endlessly. Some moms find it works better to latch baby carefully while sitting up, and then relax back into a reclined position.

    Latch issues and infections can occur at the same time. Maybe you can have your LC read you the section on bacterial infections and nipple pain in the textbook Breastfeeding Answers Made Simple to see if that fits at all.

  6. #16
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    Default Re: Need serious help and support: pain, vasospasm

    Even the best IBCLC is going to occasionally miss something. I saw 2 excellent IBCLCs, and 2 first rate pediatricians, and they all.missed my kid's lip tie. Sometimes it's a matter of time- you're just waiting for your child to grow enough that her mouth can get a deeper latch.

    with the PP that "milk drunk" is a myth. Sure, some babies have that appeance after nursing, but plenty of others don't. Mine never did.

  7. #17
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    Dec 2015
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    Default Re: Need serious help and support: pain, vasospasm

    Quote Originally Posted by @llli*mommal View Post
    Even the best IBCLC is going to occasionally miss something. I saw 2 excellent IBCLCs, and 2 first rate pediatricians, and they all.missed my kid's lip tie. Sometimes it's a matter of time- you're just waiting for your child to grow enough that her mouth can get a deeper latch.

    with the PP that "milk drunk" is a myth. Sure, some babies have that appeance after nursing, but plenty of others don't. Mine never did.
    Thanks so much to both for the comments on "milk drunk" - that's encouraging. I saw my midwife/RN and she felt confident in ruling out thrush and bacterial infection. She said neither me nor he looked "yeasty" and I don't have any other symptoms. Still getting purple, bruise-looking nipples following nursing and the vasospasm blanching. Sometimes the ridge is slightly less, but still there.

    Any thoughts on sudden, intense squirming, writhing and pulling backward while nursing? It's DEFINITELY making things worse (and hard to keep that shield on). I've read some possible reasons - flow too slow, flow too fast, gas ... how am I supposed to know which? I've tried compressions, it doesn't seem to help. Tried taking him off and burping and doing "bicycles" for gas - he mostly seems to just get angry at being taken off. When breasts are very full he takes big gulps so it seems unlikely it's too slow of a flow?

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