Any ideas? Situation getting steadily worse...

[beatofthedrum]

WWYD? I'm a seasoned breastfeeder, I managed 16 months with dd with no big problems. My lovely ds is 4 months and things are much tougher this time. My nipples have been in a horrendous mess for the last 3 weeks - I've made an effort to correct our latch but tbh there were no real problems evident so I'm not clear on what I should be changing really. I have large cuts around my nipples on both sides - they're bleeding and very painful to touch. When he latches on, I can only compare it to blunt needles being jabbed through my nipples. Pain lasts a few seconds then feels ok.

I don't want to give up. I can't really consider giving up, I want to feed him till he is 12 months, I am proud to breastfeed and love the closeness with my baby. However, nipples are spikily sore (may have made up that word! But feels like a spike!) every minute of the day and when he latches on I see stars!!

So far have:
Applied lansinoh after each feed
Been to breastfeeding support group for advice
Tried to improve latch

What should my next move be?? Any ideas?

Nipple shields? Gp?

Don't worry, someone more knowledgeable than me will be along soon.

have you tried a bf helpline? could there be a tt? (if no obvious problems with latch, but still nipple trauma)

sorry not to be able to offer anything more useful.

I had a horrifically sore nipple, cracked bleeding and scabbed, and I expressed for a week completely, gave it chance to heal and things got better really quickly.

I stopped using creams and hardly changed my breast pads :)

Thrush maybe?

I recently received a lovely hole in one nipple and as above found expressing for a few days has given it a chance to heal.

Are you still doing newborn type hold? Maybe you need to change position slightly.

Beat - it sounds a bit like thrush to me. I had sore nipples to start (just toughening up and getting the hang of it) and then things were great for a few weeks until they became really sore again but this time I had deep throbbing pain, itchy skin and stabbing spikily (an appropriate word!) pains. It is horrible feeling when you want to carry on but can't contemplate how you can when it bloody wrecks! After two nights and days of hell I headed to BF cafe and they confirmed it was thrush (it was only that morning that white spots appeared in DS's mouth) so armed with right info went to doctors and was prescribed Daktarin gel for DS and Daktarin cream for me. I actually had it again a month or so later. Both times the cream gave pretty much instant relief and felt so soothing. DS's white spots disappeared immediately. It was all back to normal in no time. If it is thrush it is really important both of you get treatment and that you continue for a week or so after symptoms disappear (sure doc will go over this).

From what I understand thrush will cause nipples to hurt between feeds and I can definitely attest to this. Did they check this at BF group? Some good info on Kellymom re thrush. Hope this helps and that you get some relief soon. Oh and I think the advice is to lay off the lansinoh when you have thrush and change breast pads after every feed (if you are using them). Keep us updated.

That is so helpful, thank you so much! I agree Dango, it does sound like thrush, just looked up Kellymom as you advised. If it is, it's gone undiagnosed for at least 3 weeks, will this make it really difficult to shift? Am on holiday at the moment too, typical. Have looked in ds's mouth but can't tell if he has actual white spots or if is remnants of last feed! Thanks very much for the help so far, now not sure whether to call NHS Direct as not sure I can wait till I get home to see my own doctor.

Don't think it'll make it hard to shift. Although I only went a few days. Suspect it will just be a case of longer to heal as you have the cuts that you described, most likely a product of having thrush for a little while. Might be good to phone a helpline for specific expertise on how best to aid the healing process on the cuts. As for thrush is not always evident in baby's mouth. Would head to docs/health centre asap, so would call NHS direct for immediate advice. You shouldn't have to endure this pain. The midwives at the BF cafe I went to were particularly emphatic about the medication (and that it must be for both) as they highlighted that a lot of docs won't come across this that often and may not treat appropriately?!? I think that it has Miconazole as an ingredient - which daktarin does. All the best. I am amazed you have withstood it for so long and continued to breast feed. I was in agony the first time and that was only a few days! Hope this aside you are having nice hollies!

Just get the drugs as per the BfN leaflet, plus probiotics. Cracks can't heal properly with thrush and it's excruciating on its own!

Dango you've been so supportive and helpful :), a top mumsnetter. Going to hopef see a holiday doc tomo, will update. Thanks to everyone else too for tips, am so relieved I posted! Japh what did you mean by probiotics?

Really glad could help Beat. How are things?

Probiotics are the good bacteria in our bodies that when they're in a good balance, help prevent nasty bacteria and fungal infections from multiplying. They get knocked out along with the nasty bacteria by antibiotics and this can lead to more infections, especially breast thrush when bfing. If you've taken antibiotics, it's often worth taking a course of probiotics afterwards. You can get capsules or powder probiotics from any good health food store - don't bopther with the yakult type drinks as they contain small doses plus sugar!

Hey there! I agree about the probiotics - I've had thrush a couple of times, and it was an important part of the recovery, both for me and DS because thrush travels through the digestive tract (you quite often get it on their bottoms too). You can get infant probiotics that come as a powder. You mix it with a drop of water or milk and give it on a spoon. DS suffered really bad wind as a result of the thrush, as well as discomfort feeding.

One thing that hasn't been mentioned on here is that the thrush fungus is not killed by a 40 degree wash. You have to wash things at 60 degrees. This was the only way I managed to stop a recurrent bout of it in both myself and DS. I wash sheets, towels, muzzies, bibs, babygrows, grobags, my bras at 60 degrees. Basically, anything that gets dribbled on or chewed, or comes into contact with his bottom.

You also need to change your nipple pads after every feed.

It's a pig of a thing to get rid of, if either of you have it, but it IS beatable.

HTH!

Thanks so much everyone. Have appt with GP tomorrow, I stupidly decided to hold on till I could get my own supportive female GP then of course it's all got worse over the weekend! Will update hopefully telling that I got the meds!

www.breastfeedingnetwork.org.uk/pdfs/BfN_Thrush_leaflet_Feb_2009.pdf

Best to print and take this so they have the meds info :-)

I suffered deep cracks in my nipples, maybe caused by thrush, but I had excellent advice re healing. Do not let them dry out and scab over. If you do then each time you latch on they will crack from the bottom and get worse. Keep them covered with Jelonet and they will soon heal up. This was what my wonderful lactation consultant advised.

Such helpful advice. Well, I got the right medication - just what you mentioned Dango - but the GP would only prescribe it for me as my baby showed 'no obvious signs' of thrush. It's true, he doesn't, but am I right in thinking if I've got it on my nipples he's bound to have it and will pass it right back to me?
Favourite GP was off today and felt this one wasn't massively clued-up on breastfeeding...

Hmmm quite likely I think, but see how it goes. Really glad to hear you are sorted. Has it given you some relief? Are cracks healing? I was advised to continue to treat DS despite symptoms disappearing. Midwives and Doc said we both must be treated and think most informational lit around thrush reiterates this.

just seen this thread, knew you'd sore nipples but this sounds awful, hope things get better with treatment. Also this is the type of issue all BFers should be told to look out for.

beat, it is essential that both of you are treated even though the doc doesn't think he has symptoms. The Daktarin gel referred to in other posts and in the thrush leaflet here can be bought over the counter. It is also worth knowing that sometimes the white patches of fungal growth are on the roof of the mouth rather than the tongue, particularly in breastfed babies.

Hello everyone. Thanks so much for all the input - I think I'm finally on the road to recovery now :)!
I started using the thrush treatment cream and intended to get corresponding gel for ds. However, I also called the BfN line to ask for advice as advised. Glad I did as they suggested trying 'rugby grip' latch just to rule out poor positioning (on the thinking that the nipple and surrounding skin would be 'pulled' in opposite direction)...and it has worked a treat!! Awkward to manage, but am having no pain now and the cracks are starting to weld together - so after all my advice-seeking it's come down to my own poor positioning!! I'm getting a home visit to observe feeding positions and get help for the future.
Have learnt lots from this thread and really appreciate all your input :). So happy to be feeding without pain!

Hurrah!! What is the "rugby grip" latch? Is it the rugby ball position with baby round the side and his head coming across under your arm onto the breast?

Yes! Feels weird and he was very surprised the first time, but it has worked! One very happy feeder now :)