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Thread: Inverted Nipples - Second Baby - Severe Nipple Pain

  1. #1

    Default Inverted Nipples - Second Baby - Severe Nipple Pain

    With my first baby I had mostly inverted nipples, and had to use a shield to latch. When she was 6 months I started to exclusively pump.

    Two years later I have baby 2, and I'm excited to try nursing again because my nipples are now "sucked out". Baby latches well and there wasn't any terrible pain other then normal soreness in the beginning. Lactation consultant said latch was perfect.

    About 3 days after she was born breastfeeding started to hurt... terribly. The nipple became umberibly tender, and when she latched it felt like razors cutting into my nipples. The sensation lasted for the first few minutes especially at latch (so bad I was crying in pain), and then would ease up a bit for the remainder of the nursing, but still hurt every time she sucked.

    Breasts were sore, itchy and hot between feedings. Babies tongue was white, but no spots in mouth or diaper rash. She also was not a fussy eater, and was gaining weight well.

    2 weeks past and no improvement, some days hurt a bit less, but most feedings were just miserable. Lactation Consultant thought it may be thrush, and gave me The oral medication Dyflucan, and had baby have Nystatin. Continued full treatment, and at first I felt less nipple sensitivity and less itchiness between feeds, but latch was still unbearable and eventually the sore nipples returned as well.

    Pediatrician confirmed baby had no thrush. Lactation Consultant noticed some lacerations on right nipple and a bifurcated nipple on left. These cuts were not healing, so I was prescribed an antibiotic to see if there was a bacterial issue. I'm in Day 5 of 13 of this antibiotic and no improvement. Cuts still there on nipple, and tenderness and extreme pain when latching - as if my whole nipple is a big cut and I'm placing baby of raw flesh.

    I am thinking this antibiotic is not going to be effective, and am worried I can't continue with the pain much longer. Baby is a month and a week now, and every two hours I dread feeding her.

    My nipples have lots of peaks and dips, and look very different before baby sucks and after (much more protruded after). Could the pain I'm feeling be related to them once being inverted? The whole breast is tender, some days itchy, and nipple is super sensitive. When I'm even a little cold my nipples hurt dramatically (assuming it is from touching my clothes and become more protruded).

    Does anyone have any suggestions I could bring up with my lactation consultant? Any inverted nipple people experience this with second baby?

    I don't want to give up. Please help- thank you for your time.

  2. #2
    Join Date
    Jun 2009
    Posts
    10,754

    Default Re: Inverted Nipples - Second Baby - Severe Nipple Pain

    So you are on an oral antibiotic and no improvement yet... I think trying an ab was a good call, but if that is doing nothing it is back to the drawing board. However since you are injured as well, I am not sure the ab would resolve all pain, so it might be premature to say it is not working.

    Obviously your injuries themselves are painful, but could thrush be contributing to the pain? How was it ruled out by pediatrician exactly? Baby not having symptoms does not rule out thrush. Babies are often asymptomatic. I wonder if you need to revisit thrush as a possibility, especially since there was some alleviation of symptoms on the diflucan. Thrush can be hard to get rid of and if baby is not treated appropriately baby simply recolonizes mom. I am pretty sure Nystatin has a dismal success rate for treating thrush, so maybe baby needs something else.

    Also I am unclear on what has been done to improve latch. Has baby been checked for tongue or lip ties? Have you tried different latch techniques, positioning adjustments? Poor latch is what would cause the injuries you are reporting. Just because latch looks good does not mean it IS good. If nursing hurts and is causing injury, that is almost certainly a latch problem. Helping mom and baby get a comfortable latch is an important part of what LCs can do for moms because that in-person expert eye on the issue is so important.

    Pain when cold sounds like vasospasm. Vasospasm, poor latch that is causing pain and injuries and preventing healing, and thrush could all be happening at the same time, alone, or in any combination. All solvable issues, but in the mean time? Owie ouch, that sounds really painful!

    Could the pain I'm feeling be related to them once being inverted?
    Is it possible your personal anatomy is part of the problem? Maybe. But many moms who never had inverted nipples can and do have the exact same problems. So there is no reason to assume that has anything to do with it.

    If your LC is stumped, perhaps she can get input from her colleagues? There is at least one professional online email list for LCs, called Lactnet, and I have seen LCs post difficult cases on there many times. I think that is also on facebook, and there are possibly multiple online professional communities. She also may have a local colleague she can call on to check you out. You might consider seeing a dermatologist to rule out thrush.

    More radical ideas- taking a break from nursing, pumping instead, and see if that helps move the healing along. There are risks of course but this may help. Usually best to still nurse baby a few times a day just to keep baby used to nursing.
    Nipple shield? I assume you have tried it as you used one before. Not any help?

    Here are some articles to take a look at. Thrush: http://www.breastfeedinginc.ca/conte...agename=doc-CP
    Vasospasm: http://www.breastfeedinginc.ca/conte...ename=doc-V-RP
    latch and positioning techniques- an overview: http://feedthebabyllc.com/latch-and-positioning/

  3. #3
    Join Date
    Jan 2017
    Posts
    31

    Default Re: Inverted Nipples - Second Baby - Severe Nipple Pain

    I have two children and had flat nipples. The initiation of breastfeeding with my firstborn was hell. I had pain for over 4 months. No thrush, no infection, just nipple damage, both outside and, I assume, inside. The reason the nipples are flat or inverted, is that the skin of the nipple is held tight attached by some membranes inside. When my son started breastfeeding, the suction was so strong, it tore those membranes. He refused the nipple shield, so I just suffered. Over time the excruciating pain during feedings went away. I breastfed him for 2 years and 2 months. After finishing, the nipples were fully sucked out and pretty much insensitive to anything (though until then I always felt uncomfortable). Soon I got a second child. Breastfeeding still goes fine (she's 1.5 years old now), no pain ever.
    Based on my experience and your story I want to raise the following points:
    * If you still have itch and other discomfort in between feedings without even touching the breasts, you most likely still have thrush or have it again. When you treat it, remember also that your diet plays an important role. If you eat lots of sugars, that's just a feast for yeast.
    * It seems possible, that your second baby tries to suck even more of your nipple out. And perhaps you have now what I had with my firstborn. There are two things you could try. A warm wet compress before feeding, it may help you relax and you will feel less pain during latching. If it already hurts before even offering the breast, you may numb the pain with a cold compress (just don't freeze the nipple!).
    * The thing which helped me most, was breast shells. I wore them between feedings. They kept my nipple largely protruded (as if it is just out of baby's mouth) and wet, so it could heal better (deep wounds on a nipple heal better if they do not dry out). Also protected from clothes and baby pressing against my chest. However, you should not wear them if you have thrush.
    * If you have a possibility, ask for a milk culture and figure out for sure, whether you have thrush, staphylococcus, some other bacterial infection or none of this.

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