So many problems, please help!

(26 Posts)
DreamySleepyNightySnoozySnooze Fri 16-Nov-12 13:16:59

Ds2 is nearly 10 weeks old. He got oral thrush in his 1st week, which passed to my right nipple. I also had an enormous crack in the same nipple, so feeding was agonising. He was prescribed Nystatin and I got Clotrimozole. I used Lansinoh by the bucketload for the crack.

After 2 weeks the thrush seemed to have cleared up, and the crack was healing, so I stopped the treatment. It came back after about a week, so this time the GP prescribed Daktarin for both of us. I have been using this ever since, and his mouth is a lot better but his tongue is still white. The GP suggested Nystatin, but I said he'd already had that so he said to keep on with the Daktarin.

I got another crack in the same nipple, but this wasn't as bad as the first, and it healed up after a week.

Is there anything else I can do to help clear up the thrush once and for all? It's been 9 bloody weeks!

The HV suggested the thrush might have got inside the ducts, so I would need different treatment and to ask the GP. The GP said that wasn't possible though, and I could only have topical treatment when BFing.

I also have a lot of problems with his latch. He doesn't always open his mouth wide enough so I have to pinch my nipple and shove it in when I get the chance. He is capable of opening wide, he just doesn't always. Once latched on he will feed fine for a while (unless it's a feed like I describe below), then start to slip off as he falls asleep, no matter how close I hold him. If I take him off to re-latch, he won't go back on. I assume he's had enough, and just carries on sucking for comfort as he falls asleep. He has been checked by a Lactation Consultant for tongue tie and he doesn't have one.

He sometimes feeds calmly, other times (usually in the evening) he thrashes about, bites, shakes his head, twists his face into me, pulls off and screams. He is really abusing my nipples, and the right nipple is incredibly painful. It feels like it's being stabbed with needles as he starts feeding, eases off during the feed, then the sharp, stabbing pain returns along with an ache after he has finished, and lasts for about an hour. I don't know if this is due to the thrush, or if he's causing damage to my nipple. It's really hard to get him in a good position to latch on because he's thrashing about so much.

I feel like we're going round in circles. Just as I think it's getting better, it gets painful again. I think I'm depressed, as I can't stop crying, and feel so awful all the time, and this is not helping. The GP is dismissive, and the lactation consultant was patronising and didn't offer any advice I couldn't find online.

I'm going to phone the breastfeeding network and la leche league this afternoon, but I wanted to ask on here too, as MN is my first port of call for advice!

Ileithyia Wed 21-Nov-12 13:59:33

That's great, hope the osteopath helps, and the tongue/lip tie are resolved soon too. grin

DreamySleepyNightySnoozySnooze Wed 21-Nov-12 12:23:50

Yes, she has. Thank you for all your fantastic help Elphaba, and everyone who offered advice and support. smile

Great to hear! Has she suggested going to Cote Royd in Huddersfield? If so - go for it. They're great there and can sort tongue tie, lip tie and do the cranial osteopathy all under one roof and the different disciplines work together which is fantastic. I believe Charlotte drops in there a lot for joint sessions with babies and mums as well.

Hope this gives you a further boost to keep persisting as brilliantly as you have been thanks

DreamySleepyNightySnoozySnooze Wed 21-Nov-12 12:03:46

An update if anyone is interested -

Charlotte from Milk Matters has just been, and she's been very helpful. He does have a tongue tie, and a lip tie. He also is very tight and 'hunched' in his shoulders and neck, probably due to the shoulder dystocia, which is affecting his breathing and movement. Also his skull is uneven and very flat in the area with all the nerves that control his face and mouth, and one side of his face is a little lower than the other. These things also may be preventing him from getting his wind up effectively, which then builds up through the day and by evening is very painful for him, which is why he bites, twists and thrashes.

She recommended he sees an osteopath for a few sessions first, then she'll review him. If we get the tt snipped now, it'll probably reattach within a couple of days because of the other problems, so we need to sort those first, then see if the tt needs snipping.

She was lovely, and it's great to have a plan of action and to know the reasons behind all the problems! smile

DreamySleepyNightySnoozySnooze Mon 19-Nov-12 20:48:10

I've had a sore right breast all day, and I've started feeling feverish. I've just gone to feed and it's bright red. Just what I need! I've already had mastitis once since he was born, and the antibiotics gave me really painful wind. sad

Serious, how can something that is the most natural thing in the world, be so fucking hard?!

The lc from Milk Matters is coming on Wednesday.

DreamySleepyNightySnoozySnooze Sat 17-Nov-12 21:51:59

Ok great, thankyou.

I've heard back from Milk Matters already! At 9pm on an Saturday night, how good's that?! They are going to put me in touch with someone local to me.

No, you don't need a referral for cranial osteopathy. Just do a Google search for one in your area, phone up and book. Easy!

Good luck with everything. Let us know how you get on. x

DreamySleepyNightySnoozySnooze Sat 17-Nov-12 20:35:59

Right, I've emailed Milk matters to book a one to one session. Hopefully they'll be able to double check the tt situation, and check the latch. If his tongue is fine then I need to know how to get him to open his mouth wider.

I've spoken to Dh about using his health insurance for cranial osteopathy and he thinks it should cover it. Does anyone know if I need to get the GP to refer him?

I'll make a GP appointment on Monday. I have a list for him - Swab for thrush, course of fluconazole if needed (I will take a printout of something if necessary), refer for cranial osteopathy if I need a referral, and my mental health situation. I can't stop crying, I felt really panicky and anxious when we were out today (it took all my will power the whole day not to beg Dh to take me home - I didn't want to be outside), I can't sleep and I keep flying off the handle about minor things. I'm really worried as I've never felt like this before. Hopefully it's just tiredness and stress.

Thank you so much for all your help everyone. You've encouraged me to do something about all these problems instead of sitting here letting them escalate as I had been doing. I still can't talk about any of it without crying and becoming an emotional wreck, but at least I've sent the email now so things are moving.

lrb1982 Sat 17-Nov-12 19:50:24

Sounds like you're having such a tough time. I agree fluconazole is the way to go, although it took a week before I noticed any improvement so get two week's worth. Also the only thing that helped my cracked nipples was a nipple shield. It was a complete revelation the first time I used it as the feed was almost pain free. I now only use one on my left side and Ds2 copes fine with that. The nipple shield also helped with his latch too. Oh and my gp also prescribed fucidin cream in case it was a bacterial infection in my cracked nipples. They said to mix that with daktarin cream but to wash off the mixture before feeding.

You are amazing for persevering for so long, I'm sure once you get the right treatment it will all get better and this will be a distant memory. Good luck.

Ileithyia Sat 17-Nov-12 10:29:38

Mrs Dimples "I had a long fight with my GP - despite the surgery midwife telling me to get a script for it - but eventually they relented and I got better."

Same here, 3 months, 12 loooooong weeks arsing around with nystatin drops (which made my baby projectile vomit hmm) and oral gel and stabbing, shooting, burning pains from nipple to armpit for me and eventually a 14 day course of fluconazole for both of us simultaneously and we were finally clear. But like yours Dreamy my GP initially insisted there were no treatments for thrush other than creams/gels/drops, I had to do my own research, print it off and present him with it before I got what I needed.

But, make sure the latch/tongue tie thing is properly investigated too, you may have thrush due to nipple/breast trauma from poor latch, sometimes it's a chicken & egg scenario.

Chin up Lovely, you're doing a brilliant job. smile

Forgot to add OP - this may seem a bit obvious, but make sure you apply the oral gel after a feed. I can remember someone on here who got told (or mistakenly understood) that she needed to apply the oral gel to her DC before a feed.

AFAIK, I don't think cranial osteopathy is available anywhere on the NHS, but hopefully your private health insurance will cover it. It's around £45 for the initial consultation then around £34 for subsequent sessions. Since your baby had the dystocia, it may well be worth pursuing. I think 3-4 sessions generally sorts things out, just so you're aware of what sort of outlay you're facing!

That's good that you're in the area for Milk Matters - hope they'll get to wherever you are and help you sort things out.

Very, very well done for persisting this long with it. You and your baby will definitely reap the benefits in the long term, and this phase will seem like a distant memory once everything's sorted.

orchidee Sat 17-Nov-12 01:44:32

The first 3m of bf were agony for me. Just cracks, no thrush so I can't comment on that. DS was checked for tt but it was thought he just had a "disorganised suck". Probably true, he was on the boob almost constantly, which didn't give the nipple cracks much chance to heal while his latch was poor. I'd have preferred a diagnosis that led to treatment though, I really thought it was tt, it'd be snipped and all would be well.. Somehow though it just got better around the 3m mark. I used the "nipple flick" technique (google it) to improve his latch. That helped a lot but I think he needed practice. We're now going strong at 18mo and it's hard to remember it being a problem, it was so long ago and once he got it, he became an expert. I'm glad we got things together eventually and hope you do too. I didn't find much rl support but people here were fab. Kellymom and the analytical armadillo too.

Good luck.

MrsDimples Sat 17-Nov-12 01:02:53

& I agree with the feeding lying down advice too. On your back.

MrsDimples Sat 17-Nov-12 00:54:35

This

"Dreamy - it sounds like you need a course of oral fluoconazole for the thrush. Your GP isn't correct about topical treatment being your only option. You do need to keep up with the cream for yourself and oral gel for your baby at the same time, and for two weeks after you finish the tablets, but a course of fluoconazole was what ultimately broke the (very long) cycle for me. "

If you Google, Breast Feeding Network & Thrush you should find a PDF leaflet where it states it can be given to BFIng women as it is prescribed to prem babies.

I had a long fight with my GP - despite the surgery midwife telling me to get a script for it - but eventually they relented and I got better.

I only had it in one breast and it had travelled to the duct. I couldn't hold my baby for two hours after feeding from it, as it was like electric shocks travelling through my body. We made it through.

Good Luck smile

LLL phone line were amazing for me smile

Ileithyia Fri 16-Nov-12 22:30:38

ABM is very good too. They my have someone local that can come and see you at home.

DreamySleepyNightySnoozySnooze Fri 16-Nov-12 22:12:41

Sorry, cross post Ileithyia. Thank you for the advice and support. You're right, I need to check it really is thrush first.

I've just been feeling so down about it, and desperately want to be able to just put him on and feed him without all the problems and faffing about with creams and gels!

DreamySleepyNightySnoozySnooze Fri 16-Nov-12 22:07:28

Thanks Elphaba, that's all really helpful stuff.

The GP told me to use the cream and oral gel twice a day! I will definitely up the applications and see if that makes a difference. I also haven't been applying it to the roof of his mouth, just the tongue and sides, so thanks for the tips.

I will go back and see a different GP about the tablets. I will also ask for swabs to be taken to check if it is actually thrush. After reading that thread you linked to it's making me question if it is purely a latch problem. He definitely had thrush before, it was all over his mouth, but now he just has a white covering on his tongue and I don't know if this is thrush or something else.

I assumed that the thrush had only got into my right nipple because that one had cracks in it that made it easier for the thrush to set in, but now you mention it he has always preferred the left side. Apparently cranial osteopathy is not available on the nhs where I live, it would have to be done privately, which wouldn't be a problem as Dh has health insurance through work that covers me and the Dcs fortunately.

He had shoulder and body dystocia when he was born, and I read that this could affect his feeding, and cranial osteopathy was recommended for that, so I will look into it.

Thank you for the Milk Matters link. I was thinking that I'd do the virtual tt id service, but then I noticed they are based in yorkshire and do home visits, so I will be calling them asap. That way if it isn't tt they can also help with positioning etc. I didn't call lll or breastfeeding network today as every time I went to dial the number I burst into tears, but Milk Matters looks much better anyway, and I can email them if I'm too upset to talk.

You've all given me a lot of great advice and support, thank you so much. grin

Ileithyia Fri 16-Nov-12 21:47:58

And well done, you're doing so well to be persevering through all these problems. smile

Ileithyia Fri 16-Nov-12 21:46:36

To help your nipples heal try wearing breast-shells between feeds, they allow air to circulate and mean you don't have to peel stuck on breast pads off your nipples at each feed.

Laid back feeding positions will help him to not slip off when he's getting sleepy, then you won't get the problem of his chewing the ends of your nipples and making them sore.

As for Thrush, there is a systemic treatment www.breastfeedingnetwork.org.uk/pdfs/dibm/FAQs_Thrush__and_Breastfeeding_Jan-2012.pdf but you need to make sure it is thrush for sure, and not pain and trauma from the latching issues.

Dreamy - it sounds like you need a course of oral fluoconazole for the thrush. Your GP isn't correct about topical treatment being your only option. You do need to keep up with the cream for yourself and oral gel for your baby at the same time, and for two weeks after you finish the tablets, but a course of fluoconazole was what ultimately broke the (very long) cycle for me. You're both on the topical treatment which is recommended by the Breast Feeding Network - are you applying it correctly? Cream after every feed for you, and oral gel four times a day for your baby. Apply it in four petit pois sized blobs - one each on the roof of the mouth, both cheeks and the tongue as far back as you can.

Definitely stop using the Lansinoh - the thrush will find it far too warm and cozy with that on there! smile Let the air get to your boobs as much as possible. Make sure you wear a clean bra every day, and try sleeping without a bra so you get better air circulation over night. I found not using breast pads useful. I also took acidophilus tablets (you can get the from places like Holland and Barrett).

One thing which does sound a bit odd, though, is you describe the symptoms as only being on one side - that generally suggests an attachment/latch problem rather than thrush which would affect both sides. There's a good MN thread here which discusses thrush and possible differential diagnoses. Does your baby prefer one side to the other? Cranial osteopathy is the current recommendation for babies with an obvious preference for one side which often leads to latch problems.

WRT the tongue tie, Milk Matters now offer a virtual tongue tie identification service. I haven't used it myself but the problems you're describing sound pretty typical so you may find it worth trying if you don't feel you have the local expertise necessary. It does cost £26 but if it means you can get things sorted, I'm sure it would be a small price to pay!

DreamySleepyNightySnoozySnooze Fri 16-Nov-12 18:40:33

Thanks for the replies. He really does tick every box for tongue tie symptoms, but I don't know who else to ask to check. GP, health visitor and midwife all said the LC I saw is the only person who can diagnose TT in my area, and she said he doesn't have one. There must be someone else, I'll ask around.

I wondered about the let-down, as it is fast, he often pulls off then gets milk spurting all over him! But the problems with biting, thrashing etc are usually in the evening when he's fed a lot and my breasts are soft and milk flow is slower. I have thought that maybe he's getting pissed off that the milk isn't flowing fast enough and he has to actually work for it. It's all guesswork though. I just wish I could know for definite.

There is a breastfeeding cafe that I've been to, ThreeWheelsGood (where I saw the LC). I didn't find it very helpful, but I will go again this week and try to be more specific in describing the problems. Just writing it all down here has really helped. I was in a flap last time as it was very busy. I sat there for an hour and by the time she got to me I had 5 minutes before I had to leave to pick up Ds1 from school. I forgot to mention loads of things. blush

Yes to Thrush liking lansinoh McBaby! I stopped using it after a while and the thrush cleared up (temporarily). The crack then healed too, because the thrush had gone I think.

McBaby Fri 16-Nov-12 18:12:59

Also how fast is your let down! Could your baby be clamping due to fast flow?

McBaby Fri 16-Nov-12 18:05:21

Get your baby checked tongue tie again! Mine was missed a number of times! All the other things you mention can be caused by tongue tie including recurrent thrush.

Also thrush likes moist dark places ie in lanolin cream. Current to heal my crack and thrush using daktarin then vasaline then jelonet a d crack is healing and keeping thrush as bay!

ThreeWheelsGood Fri 16-Nov-12 15:38:51

Please try and get some hands on help from someone - do you have breastfeeding support available through your postnatal clinic?

I feel for you. Thankfully i've not had thrush but I have had a cracked nipple and a baby who doesn't seem to open her mouth wide enough for a deep latch.it's really upsetting me too, all-consuming, but I've had good support at hospital. Also went to La leche league meeting which was reassuring.

DreamySleepyNightySnoozySnooze Fri 16-Nov-12 13:47:58

I forgot to say, he has very sharp, pointy bits on his gums which might be causing the pain. Could he be teething already? And could that be why he thrashes/bites/twists my nipples?

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