So near but not quite - mastitis? poor latch? something else?

[notcitrus]

Squirmy is 4 weeks tomorrow. I've managed to exclusively bf so far, he's putting on weight as if he'd read the charts, and feeding every 3 hours or so. Hooray!

The first couple weeks were rather painful, but as I was recovering from SPD and having trouble moving, and have RSI in my hands and wrists so very little strength, I wasn't too worried, and it was getting better as my positioning improved and my HV gave me some lanolin cream which seemed to help.

Then Squirmy and I got a cold, and he spent a couple days just sucking loads, pulling at my breasts, making them a lot more sore, and they haven't got better since.

I saw a bf counsellor on Sunday who helped with posture and figured he isn't opening his mouth quite enough. Thing is, he never tilts his head back so tickling his lip/nose with the nipple doesn't enable me to get the breast in, especially as he usually doesn't open that wide.

He gets a good mouthful of areola all round, but I think the pain is where he's made love bites and a blood blister round the edge of the areola. If I pull those away it's not bad. Sometimes it doesn't hurt at all after the initial pin-pricking latching on. But there's also burning pain inside my breasts - someone said this could be mastitis especially as I was pretty feverish last week? The pain is only when he's not feeding!

Was thinking of trying expressing just to give my nipples/surrounds a break - is that a good idea?

It's frustrating because it's so nearly working perfectly, but if the pain doesn't get better I'm going to have to quit soon.

You poor thing! It sounds as if damage already done is the problem. It can take a while for blisters to heel - if you think about having a blister on your heel and wearing the same shoes again its the same thing. Have a look at the bf links on here as there is really good advice which may help with positioning. As for mastitis, the symptoms are usually similar to flu (high temp, shivers, aching) and a red and hot area on the breast. I had mastitis twice and you really do feel rough! You have to be really careful with expressing as this too can cause trauma to the nipple. Have you tried lansinoh cream - quite pricey but definately kept me going through cracked and sore nipples. The fact that bf sometimes doesn't hurt at all after those initial toe curling 30 seconds or so, shows that you are getting it right. Keep going, you are doing so well and things will slowly improve.

the pain inside the breast sounds very like thrush to me.

very easily treatable. See gp.

I have it for the first time ever in feeding 5 children, and dd now 17 mths. Bugger it is, and very painful for quite some time after the feed is over.

does that sound familiar

If it's matitis thats causing the majority of the pains have a word with your HV. It's quite some time since I was where you are now... I was lucky to not get mastitis myself... I got chewed bleeding nippples instead! but I do remember my best friend who got mastitis really bad saying setting the showerhead to pummle velocity and having long hot showers aiming the jets at her boobs helped. Also massaging the boobs to work any mastitis lumps out. Paracetamol helped with the pain relief.

Lansinoh ointment worked the best for my poor bleeding nipples & I had to use a shield on the one that got really bad for a while. Or my toes curled up in agony everytime DS latched on!

You're doing extremely well... sticking with it in pain is sooo hard. Pat yourself on the bag and give yourself a load of gold stars

HV said if there weren'tred dots on my breast or white dots in his mouth, it wasn't thrush - and I don't have either.
It's 4 weeks until I see a HV again - will try GP.
Will keep with the paracetamol and lanisoh, and see how expressing goes once all the bits are put together.

Question - on the right (better) breast the last few times I keep feeling this thwapping sensation on what must be my nipple, which is uncomfortable and makes me tense/feel sick - but I can't figure out where to aim the nipple in his mouth to avoid it.

Can someone recommend a detailed link? i tried the Dr Jack video but it doesn't work, and most of the diagrams are too simplistic. Should the baby be completely on his side or a bit face up/down? And when they say 'top' of mouth, is that upper lip or the top as you look down, ie one end?

and thank you people for the support. I'm aiming for 6 weeks atm if it doesn't get better. If it gets better - well I'll aim for 6 months and see!

I found Claire Byam-Cook's advice invaluable when bf dd2 (gave up dd1 at 4 weeks but exclusively bf dd2 & dd3 until 6 months). Have a look at her article on www.babyworld.co.uk/information/baby/breastfeeding/teaching_tricks3.asp. Hopefully some of the advice will help. You are doing so well keep at it and it will get better. .

The pain inside your breasts after feeds really sounds like thrush to me - I'm currently struggling with it in both the nipples and my milk ducts and can attest to it being pretty agonizing. From what I've read, you don't need to see spots in the baby's mouth or on your breasts to confirm diagnosis. In my case, I think it started after the first week or two of cracked/bleeding nipples while we worked on the latch - it can enter through damaged nipples and I was using lots of Lanolin which, while good for cracks, is also ideal food for yeast as well as keeping everything nice and moist.

I also thought it was just the latch/position continuing to be a problem, despite MWs, etc. telling me it was fine and the baby gulping plenty and gaining loads of weight, until the pains in my breasts after feeds got increasingly bad - really feels like fire rushing through every blood/milk vessel. I've also noticed that although the nipples look normal immediately after a feed, within a few minutes, they start to have paler patches on them.

I've now changed my diet to cut out all carbs and sugar, am taking flucozanole prescribed by my GP (now in a higher dosage as the first course last week didn't seem to help much), using clomitrazole cream on the nipples and taking acidophilus, garlic and grapefruit seed extract supplements. The baby gets Nystatin suspension 4x day. I'm keeping my fingers crossed that it works this time which I suppose will definitively confirm the thrush diagnosis and make BFing something I look forward to rather than dread.

Sorry for the essay - I just sympathize fully as it sounds a lot like what I've been going through.

Thankspeople. I think it may be thrush too - hopefully I can take diflucan or similar as I'm allergic to canasten?
Would have tried GP today but my dad is visiting to look after A and let me sleep. Has he turned up yet? No. Bah.

I have Clare Byam-Cook's book somewhere in the house which was invaluable when I got out of hospital - will try to re-read.