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Nipple shield...EDIT!

Posted by on May. 13, 2013 at 9:30 AM
  • 15 Replies

i started using one today. :-( my nipples are getting worse...wtf? im almost 10 weeks into BF'ing and Im getting REALLY tired of being in  pain every time I nurse. :-( wth is going on? 

Here's my story from start to now..

I had a c section in the hospital and they wouldnt let me sit up AT ALL for 30 hours. LIke not even lift my head off the pillow or sit in a reclined position. They were worried about a spinal headache. So I nursed like that for 30 hours and needless to say, my left breast got cracked. It hurt but all the LC's said it was not damaged, it looked fine and that it was normal for things to hurt. When I got home, the pain didnt stop. I had yet another LC come visit me a few weeks afterwards to check things out...I told her it still hurt, but she said the same thing...its normal blah blah blah. My latch was good, yada yada. Well, after doing some research, I found that the latch was NOT good. It was too shallow, so I had to retrain Nathan and myself to latch correctly. For a while he only got it right 50 percent of the time. Well, after more research and colic like symptoms, I realized that the reason he was not latching so well was because of oversupply and OAL. We had him checked for lip and tounge tie, so I know it wasent that. I did block feedings for 6 weeks to get it under control. And I succeeded. During that time, I tried repeatedly to heal my damaged nipple, (which was still causing me lots of pain) and sometimes it would get kind of better but never 100 percent. This whole time, my other nipple had been fine. Well, about 3 weeks ago, that changed too. each one has lines and what look like crevaces so Im assuming they are cracks? They just wont heal and then the kind of pain kind of changed....there was a burning sensation too. I thought for sure thrush, but didnt see any white patches in Nathan's mouth. Nothing, so I let it go. THEN, I noticed that my nipples were kind of white and at first I thought vasospasims. I was researching for a few days trying to tell if that was what was wrong. During this time, my FIRST bad nipple developed 2 blebs. Iread on kelly mom that if you get more than one at a time, its most surely thrush. So that's where I am now. Damaged nipples that wont heal and I think, thrush too. THe only symptom of thrush that Nathan shows, is pulling away at the breast towards the end of a feed. No rashes. So, what do you think? Ive been doing saline soaks for a month now, used lanolin, sunning, and Ive been going topless almost 100 percent while IM at home. If I AM wearing a bra, taking both breasts out while nursing...keeping nursing pads dry, (although I dont really use them too much at this point..only when I leave the house to be safe) and Ive been doing a combo of GSE and probiotics for the last three days. (for both Nathan AND myself) In the first 12 hours, I felt like the pain was going away a LITTLE bit, but now it feels worse! :-( Im almost at the point where its too painful to nurse on the left breast. I have not used any creams or lanolin since I started to suspect thrush because I thought it was not good, but I NEED the lanolin. Using that is the only time my breasts felt KIND of better. Can I go back to using that too? What should I do about this situation? Im starting to get frustrated. Nathan will be 10 weeks this Thursday. Any ideas would be GREATLY appreciated. THANK YOU!

Why am I STILL in so much pain?? 

PS. Nathan IS now developing a bit of a red bottom.... :-(

by on May. 13, 2013 at 9:30 AM
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Replies (1-10):
veganistic
by on May. 13, 2013 at 9:38 AM
Hopefully the more experienced ladies can give you more advice, but for your nips you can google jack newmans all purpose nipple ointment. It has an antifungal in it, may help.
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IrishIz
by Silver Member on May. 13, 2013 at 9:57 AM

Is his latch correct 100% of the time?  With damaged nipples latching poorly even a few times can really just make things worse.  Is the pain only during the latch?  Does it continue after he latches?  Are your nipples every white?

If the lanolin is helping I would use that after treatment with the GSE.  Sometime it isn't thrush but actually an infection at the nipples (there is some belief that thrush isn't as common as we think).  

amc103
by Alli on May. 13, 2013 at 10:09 AM

Thank you! I would KILL for some APNO, but Im in Poland and you cant get it here. :-(

Quoting veganistic:

Hopefully the more experienced ladies can give you more advice, but for your nips you can google jack newmans all purpose nipple ointment. It has an antifungal in it, may help.


amc103
by Alli on May. 13, 2013 at 10:13 AM

I think he's a lazy latcher. Since he learned to pull off with the OAL, it takes a few times EVERY nursing session to get him to latch correctly. I think the only times his latch has not been 100 percent is with side lying in bed. :-/ Right nipple pain-only for the first 2-3 minutes of the feeding. Left nipple used to be the same but now its for the whole feeding. My nipples get white sometimes. I noticed after the shower somtimes the get white for like 40 seconds then go back to pink. this happens every so often after a feeding too. then the other night, when I noticed my blebs on the left nipple, the right one had some white patches on it that didnt go away. I dont see them now. I did use the lanolin again today..I just had to. But I noticed when I wanted to applly the GSE, it didnt really soak in because of the lanolin! :-( :-( Grrr...what to do? 

Quoting IrishIz:

Is his latch correct 100% of the time?  With damaged nipples latching poorly even a few times can really just make things worse.  Is the pain only during the latch?  Does it continue after he latches?  Are your nipples every white?

If the lanolin is helping I would use that after treatment with the GSE.  Sometime it isn't thrush but actually an infection at the nipples (there is some belief that thrush isn't as common as we think).  


IrishIz
by Silver Member on May. 13, 2013 at 10:19 AM

I wonder if there is some vaso constriction going on.  If you keep your breasts and nipples warm...does that help any?  Is he clamping down on the nipple?  The blanching can be from a few things and could be the cause of pain.  

I would use the GSE and then the lanolin.  When you need to reapply the GSE soak the nipple in some warm water first to remove the lanolin.  


Quoting amc103:

I think he's a lazy latcher. Since he learned to pull off with the OAL, it takes a few times EVERY nursing session to get him to latch correctly. I think the only times his latch has not been 100 percent is with side lying in bed. :-/ Right nipple pain-only for the first 2-3 minutes of the feeding. Left nipple used to be the same but now its for the whole feeding. My nipples get white sometimes. I noticed after the shower somtimes the get white for like 40 seconds then go back to pink. this happens every so often after a feeding too. then the other night, when I noticed my blebs on the left nipple, the right one had some white patches on it that didnt go away. I dont see them now. I did use the lanolin again today..I just had to. But I noticed when I wanted to applly the GSE, it didnt really soak in because of the lanolin! :-( :-( Grrr...what to do? 

Quoting IrishIz:

Is his latch correct 100% of the time?  With damaged nipples latching poorly even a few times can really just make things worse.  Is the pain only during the latch?  Does it continue after he latches?  Are your nipples every white?

If the lanolin is helping I would use that after treatment with the GSE.  Sometime it isn't thrush but actually an infection at the nipples (there is some belief that thrush isn't as common as we think).  



amc103
by Alli on May. 13, 2013 at 10:39 AM

He does sometimes bite down, like if he's falling asleep or if he looses the suction for some reason, he bites down to keep the nipple from falling out, I guess! Ive noticed a few times, just in the last week, that he bites down a bit when he's zoned out on the breast. :-( 

Hey, my hubby just called me. We live in Poland and I asked him to get GV at the pharmacy. He just told me that the phramacist gave him 2 kinds. One is GV water, for baby's mouth, that Im not supposed to give him just before or just after a feeding because she  said he will vomit...and GV with alcohol for my breasts. How does that differ from the one kind of GV you can get in the States, do you know? I was like, "huh? Two kinds of gentian violet?" LOL!

Quoting IrishIz:

I wonder if there is some vaso constriction going on.  If you keep your breasts and nipples warm...does that help any?  Is he clamping down on the nipple?  The blanching can be from a few things and could be the cause of pain.  

I would use the GSE and then the lanolin.  When you need to reapply the GSE soak the nipple in some warm water first to remove the lanolin.  


Quoting amc103:

I think he's a lazy latcher. Since he learned to pull off with the OAL, it takes a few times EVERY nursing session to get him to latch correctly. I think the only times his latch has not been 100 percent is with side lying in bed. :-/ Right nipple pain-only for the first 2-3 minutes of the feeding. Left nipple used to be the same but now its for the whole feeding. My nipples get white sometimes. I noticed after the shower somtimes the get white for like 40 seconds then go back to pink. this happens every so often after a feeding too. then the other night, when I noticed my blebs on the left nipple, the right one had some white patches on it that didnt go away. I dont see them now. I did use the lanolin again today..I just had to. But I noticed when I wanted to applly the GSE, it didnt really soak in because of the lanolin! :-( :-( Grrr...what to do? 

Quoting IrishIz:

Is his latch correct 100% of the time?  With damaged nipples latching poorly even a few times can really just make things worse.  Is the pain only during the latch?  Does it continue after he latches?  Are your nipples every white?

If the lanolin is helping I would use that after treatment with the GSE.  Sometime it isn't thrush but actually an infection at the nipples (there is some belief that thrush isn't as common as we think).  




gdiamante
by Group Mod - Gina on May. 13, 2013 at 10:40 AM


Quoting amc103:

i started using one today. :-( my nipples are getting worse...wtf? im almost 10 weeks into BF'ing and Im getting REALLY tired of being in  pain every time I nurse. :-( wth is going on? 

You have thrush. Did hubby get the GV?

Here's my story from start to now..

I had a c section in the hospital and they wouldnt let me sit up AT ALL for 30 hours. LIke not even lift my head off the pillow or sit in a reclined position. They were worried about a spinal headache. So I nursed like that for 30 hours and needless to say, my left breast got cracked. It hurt but all the LC's said it was not damaged, it looked fine and that it was normal for things to hurt. When I got home, the pain didnt stop. I had yet another LC come visit me a few weeks afterwards to check things out...I told her it still hurt, but she said the same thing...its normal blah blah blah. My latch was good, yada yada.

And you got a bad LC. You said you're in Poland... military? Sadly military medicine tends to be really bad for anyone who's not a wounded soldier.

Well, after doing some research, I found that the latch was NOT good. It was too shallow, so I had to retrain Nathan and myself to latch correctly. For a while he only got it right 50 percent of the time.

That means you were winning the battle. It takes time.

Well, after more research and colic like symptoms, I realized that the reason he was not latching so well was because of oversupply and OAL. We had him checked for lip and tounge tie, so I know it wasent that.

Just be advised sometimes docs miss the ties.

I did block feedings for 6 weeks to get it under control. And I succeeded. During that time, I tried repeatedly to heal my damaged nipple, (which was still causing me lots of pain) and sometimes it would get kind of better but never 100 percent. This whole time, my other nipple had been fine. Well, about 3 weeks ago, that changed too. each one has lines and what look like crevaces so Im assuming they are cracks? They just wont heal and then the kind of pain kind of changed....there was a burning sensation too. I thought for sure thrush, but didnt see any white patches in Nathan's mouth.

Don't look for white patches. They're absent as often as they are present and they're the last thing I'd look for.

Nothing, so I let it go. THEN, I noticed that my nipples were kind of white and at first I thought vasospasims. I was researching for a few days trying to tell if that was what was wrong. During this time, my FIRST bad nipple developed 2 blebs. Iread on kelly mom that if you get more than one at a time, its most surely thrush. So that's where I am now. Damaged nipples that wont heal and I think, thrush too. THe only symptom of thrush that Nathan shows, is pulling away at the breast towards the end of a feed. No rashes. So, what do you think?

You have thrush. Baby can be 100% asymptomatic. Both of you need treating.

Ive been doing saline soaks for a month now, used lanolin, sunning, and Ive been going topless almost 100 percent while IM at home.

Drop lanolin from your routine; it can worsen thrush. If you haven't started the GV, do so. (I still need to read all the way through... may have more later.)

If I AM wearing a bra, taking both breasts out while nursing...keeping nursing pads dry, (although I dont really use them too much at this point..only when I leave the house to be safe) and Ive been doing a combo of GSE and probiotics for the last three days. (for both Nathan AND myself) In the first 12 hours, I felt like the pain was going away a LITTLE bit, but now it feels worse! :-( Im almost at the point where its too painful to nurse on the left breast. I have not used any creams or lanolin since I started to suspect thrush because I thought it was not good, but I NEED the lanolin. Using that is the only time my breasts felt KIND of better. Can I go back to using that too? What should I do about this situation? Im starting to get frustrated. Nathan will be 10 weeks this Thursday. Any ideas would be GREATLY appreciated. THANK YOU!

Why am I STILL in so much pain?? 

PS. Nathan IS now developing a bit of a red bottom.... :-(

You both have thrush. Start the Gentian Violet ASAP.


amc103
by Alli on May. 13, 2013 at 10:47 AM

Thank you!!!! He JUST called me and said that he got 2 kinds?? One is a GV water for the baby, which Im not supposed to give him right before or after a feeding because she said he'd vomit? The other is GV with alcohol for my breasts. Are either of these the kind that you can get in the US? I never got any there with my first child. GRRR! Sometimes I hate living here! 

Thank you for the recipe for APNO.....Im going to take it to my OBGYN on Thrusday and see if she can write me a script for it. FINGERS CROSSED!!!! Lordy, I cant wait for all of this to be OVER WITH. Sigh....not giving up though. We've come too far.

Oh, and we're not military, btw, we moved here because of the economy in the US at the time was horrid and we both lost our jobs right after my first child was born. Been here almost 4 years. We just have public freaking terrible health care! UGG!  

Quoting gdiamante:


Quoting amc103:

i started using one today. :-( my nipples are getting worse...wtf? im almost 10 weeks into BF'ing and Im getting REALLY tired of being in  pain every time I nurse. :-( wth is going on? 

You have thrush. Did hubby get the GV?

Here's my story from start to now..

I had a c section in the hospital and they wouldnt let me sit up AT ALL for 30 hours. LIke not even lift my head off the pillow or sit in a reclined position. They were worried about a spinal headache. So I nursed like that for 30 hours and needless to say, my left breast got cracked. It hurt but all the LC's said it was not damaged, it looked fine and that it was normal for things to hurt. When I got home, the pain didnt stop. I had yet another LC come visit me a few weeks afterwards to check things out...I told her it still hurt, but she said the same thing...its normal blah blah blah. My latch was good, yada yada.

And you got a bad LC. You said you're in Poland... military? Sadly military medicine tends to be really bad for anyone who's not a wounded soldier.

Well, after doing some research, I found that the latch was NOT good. It was too shallow, so I had to retrain Nathan and myself to latch correctly. For a while he only got it right 50 percent of the time.

That means you were winning the battle. It takes time.

Well, after more research and colic like symptoms, I realized that the reason he was not latching so well was because of oversupply and OAL. We had him checked for lip and tounge tie, so I know it wasent that.

Just be advised sometimes docs miss the ties.

I did block feedings for 6 weeks to get it under control. And I succeeded. During that time, I tried repeatedly to heal my damaged nipple, (which was still causing me lots of pain) and sometimes it would get kind of better but never 100 percent. This whole time, my other nipple had been fine. Well, about 3 weeks ago, that changed too. each one has lines and what look like crevaces so Im assuming they are cracks? They just wont heal and then the kind of pain kind of changed....there was a burning sensation too. I thought for sure thrush, but didnt see any white patches in Nathan's mouth.

Don't look for white patches. They're absent as often as they are present and they're the last thing I'd look for.

Nothing, so I let it go. THEN, I noticed that my nipples were kind of white and at first I thought vasospasims. I was researching for a few days trying to tell if that was what was wrong. During this time, my FIRST bad nipple developed 2 blebs. Iread on kelly mom that if you get more than one at a time, its most surely thrush. So that's where I am now. Damaged nipples that wont heal and I think, thrush too. THe only symptom of thrush that Nathan shows, is pulling away at the breast towards the end of a feed. No rashes. So, what do you think?

You have thrush. Baby can be 100% asymptomatic. Both of you need treating.

Ive been doing saline soaks for a month now, used lanolin, sunning, and Ive been going topless almost 100 percent while IM at home.

Drop lanolin from your routine; it can worsen thrush. If you haven't started the GV, do so. (I still need to read all the way through... may have more later.)

If I AM wearing a bra, taking both breasts out while nursing...keeping nursing pads dry, (although I dont really use them too much at this point..only when I leave the house to be safe) and Ive been doing a combo of GSE and probiotics for the last three days. (for both Nathan AND myself) In the first 12 hours, I felt like the pain was going away a LITTLE bit, but now it feels worse! :-( Im almost at the point where its too painful to nurse on the left breast. I have not used any creams or lanolin since I started to suspect thrush because I thought it was not good, but I NEED the lanolin. Using that is the only time my breasts felt KIND of better. Can I go back to using that too? What should I do about this situation? Im starting to get frustrated. Nathan will be 10 weeks this Thursday. Any ideas would be GREATLY appreciated. THANK YOU!

Why am I STILL in so much pain?? 

PS. Nathan IS now developing a bit of a red bottom.... :-(

You both have thrush. Start the Gentian Violet ASAP.



K8wizzo
by Kate on May. 13, 2013 at 10:51 AM

It sounds like a combo of poor latch, thrush, and vasospasm.  I've been there and I know it sucks. :(  The good news is that it can get better--you know that my Nathan made it to 3 years old, so obviously we overcame that.  Here's some good vasospasm info from kellymom.  The heat (on nipples, and just generally keeping warm--I keep my shoulders and abdomen covered and that helps), b6 and cal/mag are really helpful.

Nipple blanching and vasospasm

JULY 27, 2011. Posted in: BF CONCERNS: MOTHER

By Kelly Bonyata, BS, IBCLC

Nipple blanching (turning white) after a feeding occurs when the blood flow to the nipple is limited or cut off. Blanching is most often related to latch problems. Nipple blanching is often, but not always, associated with pain. Because women may describe shooting, burning breast/nipple pain, this can be mistakenly diagnosed as thrush. If the normal color returns after your baby has finished a feeding and there is no pain, then the blanching is not a problem.

Compression blanching | Vasospasm | Treatment options | Resources

Blanching due to compression

The most common reason for nipple blanching is that that baby is compressing the nipple while nursing. This can be due to:

When blanching is due to baby’s compression of the nipple, the nipple is white and often misformed (flattened, creased, pointed, etc.) immediately upon coming out of baby’s mouth. There may be a white stripe across the nipple directly after nursing. Pain may not start until a few seconds to a few minutes after nursing, as the circulation returns to the nipple. If you are experiencing pain with the blanching, then finding and remedying the underlying cause will also eliminate the blanching.

Blanching due to vasospasm

Vasospasm, which is more severe, is a sudden constriction/narrowing of a blood vessel (in the nipple, in this case) that is extremely painful. It might occur a short time after nursing or in between nursings. Vasospasm can have various causes:

Vasospasm can be a secondary response to pain or nipple trauma (damaged nipples orthrush). In this case, the nipple(s) turns white shortly after nursing (rather than coming out of baby’s mouth white and misformed). Mom might notice a white circle on the face of the nipple a few seconds to a few minutes after breastfeeding. Cold often triggers the vasospasm and/or makes it worse. Unlike blanching due to compression, latch and positioning may be fine if the source of any nipple damage has already been fixed. Healing the nipple trauma or other source of pain should eliminate the vasospasms, although they may persist for a short time after the nipple has healed (previously damaged tissue can remain sensitive for a time).

Raynaud’s of the nipple

Vasospasm can also be caused by Raynaud’s Phenomenon (more info here), which causes sudden vasospasms in the extremities. When nipple vasospasm is caused by Raynaud’s Phenomenon (Raynaud’s of the nipple), the nipple turns white, then there is usually a noticeable triphasic color change – from white to blue to red – as blood flow returns. The color change may also be biphasic – from white to blue.

Vasospasm due to Raynaud’s is more likely to occur on both sides (rather than just one nipple), lasts for relatively long periods of time (rather than for a few seconds or a few minutes), and can occur during pregnancy and/or at times unrelated to feeding. Vasospasms may also occur in fingers or toes. Cold typically triggers the vasospasm and/or makes it worse. Nipple trauma (and other causes of compression blanching or vasospasm) can exacerbate the problem. Raynaud’s phenomenon may recur with subsequent pregnancies/breastfeeding, so be prepared to seek treatment quickly if you have experienced this in the past.

Per Anderson et al, “Because the breast pain associated with Raynaud’s phenomenon is so severe and throbbing, it is often mistaken for Candida albicans [yeast] infection. It is not unusual for mothers who have Raynaud’s phenomenon of the nipple to be treated inappropriately and often repeatedly for C albicans infections with topical or systemic antifungal agents.”

Keep in mind that Raynaud’s is not caused by breastfeeding (anyone might have it) — it simply has the potential to affect breastfeeding. For example, any person might have inverted nipples, which might or might not affect a mother’s breastfeeding relationship (as this can make latching or sore nipples more of a challenge in the beginning). Raynaud’s works the same way – anyonemight have it coming into breastfeeding, and it might (or might not) affect the breastfeeding relationship if the vasospasms are triggered by bad latch, a sudden temperature change as baby unlatches, etc.

Some maternal medications have been associated with vasospasm, including oral contraceptives. Fibromyalgia, rheumatologic diseases (eg, systemic lupus erythematosus or rheumatoid arthritis), endocrine diseases (eg, hypothyroidism or carcinoid), and prior breast surgery have also been associated with Raynaud’s phenomenon. Some sources indicate that the antifungal medication fluconazole may be associated with vasospasm, although the manufacturer does not report this as a known complication of fluconazole use. Other sources feel that vasospasms experienced by mothers taking fluconazole are a result of nipple pain/trauma due to thrush (and not due to the medication used to treat the thrush).

Treatment options for vasospasm

  • Avoid cold. Apply dry heat to the breast when needed (this relaxes the “cramping” blood vessels). Some mothers benefit from keeping the entire body warm (warm clothing, warm room, wrap up in a blanket, etc.)
  • Cover the nipple as soon as possible after baby comes off the breast. Some moms say that it is helpful use a wool breast pad or a soft cloth diaper.
  • Apply dry heat immediately after breastfeeding. A rice sock can be useful as a source of dry heat: Fill a sock or a cloth bag with uncooked rice and microwave 45 seconds (or until desired warmth is achieved); hold the rice sock against the nipple (over the cloth or mom’s shirt) until blood flow resumes.
  • Avoid caffeine, nicotine and other vasoconstrictive drugs, as they can precipitate symptoms.
  • Ibuprofen.
  • Dietary supplementation with calcium/magnesium.
  • Dietary supplementation with vitamin B6.
  • Low dose oral nifedipine.

See links below for additional details.

 

Additional information and references

Nipple pain – links 

Nipple compression stripe by Kathy Kuhn, IBCLC

Baby clamps down during breastfeeding by Debbie Donovan, IBCLC

Clampdown Bite Reflex by Mary Jozwiak, from Leaven, Vol. 30 No. 4, July-August 1994, pp. 53-4.

Nipple Vasospasm -A Manifestation Of Raynaud’s Phenomenon and a Preventable Cause of Breastfeeding Failure by Laureen Lawlor-Smith BMBS IBCLC and Carolyn Lawlor-Smith BMBS IBCLC FRACGP

Vasospasm and Raynaud’s Phenomenon by Jack Newman, MD

Nipple blanching: “My nipples turn white” by Debbi Donovan, IBCLC

Nipple vasospasm by Kathy Kuhn, IBCLC

Does nipple vasospasm recur? by Debbie Donovan, IBCLC

Raynaud’s Syndrome and Breastfeeding by Cher Sealy, RN, BSN, IBCLC, LLLL

Seeking Relief by Debbie Granick, from New Beginnings, Vol. 16 No. 3,
July-August 1999, p. 120.

References

Anderson JE, Held N, Wright K. Raynaud’s Phenomenon of the Nipple: A Treatable Cause of Painful Breastfeeding. Pediatrics. 2004 Apr;113(4):e360-4.

Garrison CP. Nipple vasospasms, Raynaud’s syndrome, and nifedipine (case report). J Hum Lact. 2002 Nov;18(4):382-5.

Riordan J and Auerbach K. Breastfeeding and Human Lactation, 2nd ed. Boston and London: Jones and Bartlett 1999, p. 492-493.

Lawlor-Smith L, Lawlor-Smith C. Raynaud’s phenomenon of the nipple: a preventable cause of breastfeeding failure? Med J Aust. 1997 Apr 21;166(8):448.

Lawlor-Smith L, Lawlor-Smith C. Vasospasm of the nipple – a manifestation of Raynaud’s phenomenon: case reportsBMJ. 1997 Mar 1;314(7081):644-5.

Snyder JB. [letter]. J Hum Lact. 1994 Sept;10(3):153.

Escott R. Vasospasm of the nipple: another case [letter]. J Hum Lact. 1994 Mar;10(1):6.

Coates MM. Nipple pain related to vasospasm in the nipple? J Hum Lact. 1992 Sep;8(3):153.

An Overview of Solutions to Breastfeeding and Sucking Problems by Susan Meintz Maher, IBCLC, La Leche League 1988, p 14.

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