Re: I need help!! No access to LLL leader or Lactation consultant...
Thanks for answering all those questions! Based on your answers, I'm thinking that there are 2 strong possible causes for the pain you're having.
The first is oversupply/overactive letdown (OS/OALD).
OS/OALD would explain the burning/tingling, particularly when it occurs along with your MER. It also perfectly explains the coughing/gagging/choking and the squirting/streaming milk. The lipstick nipple can also be a product of OS/OALD- the baby "slips up" onto the nipple in order to compress it and thereby control the milk flow. My lactation consultant compared it to the baby "crimping the straw." And it also explains that "white callous"- one thing that can happen as a result of compression is vasospasm, which can cause the nipples to blanch and which is very painful.
Two more questions:
- What are the baby's poops like? Mustard yellow and seedy/curdy (like cheap mustard mixed with cottage cheese or yogurt), or greenish/brownish and watery/foamy?
- Are you engorged at all?
If the poops are yellow and curdy/seedy, then you may have OALD without OS or at least without significant OS. If they're greenish and watery and/or you're often engorged, then you probably have OS in addition to OALD. This impacts how you should manage the problem: if you have OALD alone, you should probably manage the problem with positioning. If it's OS/OALD, you may also need to do some block feeding.
However, all of that doesn't rule out the second possibility, which is thrush. Thrush would explain the burning pain, he pink/red nipples, and the cracked, dry skin.
Unfortunately, it is possible to have both OS/OALD and thrush simultaneously. The first thing I would do is to try the positioning tips in the first link I posted. If necessary, I would progress to block feeding. I would also contact your baby's pediatrician and your midwife or obstetrician and talk to them about the possibility of thrush. But if they just take a brief look in the baby's mouth and say "nope, not thrush," I would seek another opinion since many docs know only to look for the classic sign of thrush (white, pearly patches in the baby's mouth) and do not realize that it is possible for thrush to be present without the classic symptom. In addition, many practitioners don't realize that if it is thrush, both mama and baby must be treated even if one member of the nursing pair is asymptomatic.
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