HELP! deep pain after feeding, being given conflicting advice!

[Lib76]

DS2 is 5 wks old. Bf for first 2 wks fine. needed anti-biotics for wound infection (emcs). Developed deep pain after feeding about a wk after stopping anti-biotics, had cracked nipples but managed to heal them with lanisoh and expressing. Saw GP last Fri and she diagnosed thrush, both got treatment including fluclonazole for me. Now nearly a wk later still deep breast pain and very sensitive nipples. Phoned gp today which wasn't the same one as before and he said thrush wouldn't cause deep pain and he suspected mastitis, so has prescribed AB's! To fill you on i had an awful experience with DS1 when BF and developed severe mastitis and ended up in hospital for 3 days i was so ill! so i am very aware of what mastitis is like and i don't appear to have any symptoms. Saw HV today and she said it may be non-infective mastitis and to take painkillers! Arghh!! 3 sets of advice and i am feeling a bit down about it! DS can be a little lazy with the wide mouth and my nipples are cracked AGAIN! help!! x

If you know what mastitis feels like and don't have a temperature, I'd go with your gut feeling and original diagnosis and avoid the ABs. If it is thrush, ABs will only make it worse. Do you have any lumps, swelling, redness or any other signs of mastitis.

When I had thrush, I was 10 days into a 2 week course of flucanazole before I started to feel better - and that was with gel for DD and my nipples, rigorous hygiene, probiotics and anti-yeast supplements too.

Oh and definitely take painkillers!

thanks. Yeh no redness, lumps, swelling and i feel well. GP was having none of it and refused to give me more fluconazole! i know if i had spoken to GP i saw before she would have given me more. Should i avoid lanisoh? taking pro-biotics and trying to cut back chocolate...not easy!

Sounds like thrush. I had to print off leaflets from the Breast feeding network ( I think) about the dosage of fluconazole to show my GP - the initial dose I was given was far too low. I would be quite pushy with the GP, beause thrush is awful and fluconazole is effective. Hope you get some relief soon.

Here's a brilliant leaflet on thrush written by a pharmacist who understands drugs and lactation:

www.breastfeedingnetwork.org.uk/thrush-and-breastfeeding.html

I would definately avoid antibiotics unless you're sure it's infected mastitis (which you seem confident it's not). The advice isn't entirely contradictory, even if the treatment is, as all of them are feasible... but which is it??!

Firstly, did you get the full fluconazole treatment per the leaflet, or just a one-off tablet? If just the one-off, you may well just have not cleared the thrush yet, so if you feel it's that, a trip to the original GP armed with the leaflet may be a good plan. In the meantime your HV's suggestion to take painkillers is also a good one if you're struggling. I would advise following the normal advice about treating thrush which includes washing your bra each day at 60 degrees, and ironing the inside to kill spores and drying your breasts with a fresh towel after a shower or bath (or a facecloth to minimise washing).

Did you get Daktarin gel for bub and cream for you?

It sounds like what I have had! I was told by my GP that it was a deep tissue thrush infection. It felt like a sharp, deep pain. I did also have nipple problems.( I had absess and mastitis, with my first!) with my Cracked, bleeding nipples etc. I know exactly how you are feeling. I initially had ABs which had side effect of thrush. gP told me that to treat, I would have to be on fluconazole for a sustained amount of time, it ended up about ten weeks! My little one is now six months and it is fine. I would advise painkillers and doc also suggested gin and tonic as she knew what I was going through! Can I suggest Kamillosan nipple cream (in a yellow tube) really good for me. Has baby got thrush? Little White plaques on Tongue?

Not sure about lansinoh if you have an open crack. I would demand to see the GP you saw first tomorrow.

I washed my nipples in a white vinegar solution (1T in 1 cup water) and felt it did help. I stopped after my HV said it was drying, and had a relapse! Keep it away from the cracks though.

Don't know about thrush or the other things but I used Lansinoh on cracked nipples for 4 weeks or so and didn't develop any other problems - I couldn't have fed DD without softening the cracks with Lansinoh first and the problem started to resolve when I kept them 'moist' (although DD fed [feeds] lots and OFTEN!). Not sure if this is recommended, just what I did.

Thanks for all your replies most helpful. Last night i just gave ds ebm and expressed during night when i got full, nipples feel much better and have used lanisoh again. Haven't taken anti-biotics as no mastitis. deep pain has not been present today but have been taking brufen so that may be helping. organic have read that leaflet before, very interesting and helpful. I got nystatin for ds and canesten for me and for his bottom. not really seen much evidence in DS mouth tbh. doublesmummy will try kamillosan, thanks for tip!

i think the overall problem is DS latch at times, he is sometimes really bad at opening his mouth wide enough and ends up pulling on me! Off on holiday tomorrow (staying in Scotland!) so fingers crossed things improve!

Kamillosan you can get on prescription (ie free).

Nystatin isn't really any good for bub's mouth, and canestan is not really ideal for your nipples, either, as it can cause skin reactions. Daktarin gel for bub's mouth, and Daktarin cream for you would be better, if it is thrush.

Can he SOMETIMES open his mouth ok - or does he never do? If he isn't opening it properly all the time, it may be due to TT? This can cause awful nipple pain, but also deep breast pain because it's not been drained properly.

More symptoms here: www.ann-dobson.co.uk/tongue-tie_symptoms.html