Can I bottle feed for a few days to allow nipples to heal???

[brownster]

I have a nasty case of thrush and this combined with some positioning issues have caused my poor nipples to become cracked, bleeding etc, one is split from one side to other. So every time I feed DD they are opening up again. She is sicking up blood and feeding is now so painful I can't cope much longer. I don't want to give up BF so it has been suggested that I give her some formula for a day or so, and express at same time to keep up supply, in order to let nips heal. Expressing still hurts but is better than those hard little gums. Any thoughts as am at the end of my tether ???

HAve you and baby been treated for thrush - is it all cleared up? How old is your lo? I personally think the best thing you can do for sore nipples is to give them plenty of air - prob best if you aren't expecting visitors - express some milk after every feed and allow it to dry on them. Don't use soap anywhere near them when you are having a bath/shower as this will dry them out more. Also, you mention positioning issues and the hard little gums being sore on your nipples but your nipple should actually be at the back of the baby's mouth on the baby's soft palate - out of harms way! It might be worthwhile seeing a bfc in RL to make sure your positioning is ok. Hope you feel better soon xo

Thanks for the advice . We are both currently being treated for the thrush, the pain within the breast is getting better, it's the nipples now, am letting them air dry and then slapping the cream on. She is only 6 wks old so don't want to give up the BF, looking for ways round it as can't bear to feed her. I spoke to a BFC from NCT on the phone and she has given me some positioning tips as I am quite large in the breast department, will also get this checked at my BF group.

i would make sure the thrush treatment is effective as it is v hard to get hold of the stuff that actually works. flucanazole worked for me but i almost had to sign in blood that i knew it was recommended for breatfeeding (actually breastfeedingleague or something recommended it). but i wouldnt recommend stopping feeding for a few dyas to be honest hard though it is. i went through this 5 times with dd1 and it was excruxiating the pain until it was properly sorted out. i feel for you. you sounds like a wonderful mum

Brownster, I found the first weeks of bf the most painful thing ever, and we both got thrust too. My nips were knackered - I got some breast shells (NOT shields) to wear between feeds, as I couldn't bear anything touching them. They really helped with healing. I know lots of people say to slather on Lansinoh too, but my lovely mw told me to be 'mean with the cream' and use a little EBM after each feed.

brownster - I agree you need good real life help with this.

It can help sometimes to let the nipples heal if things are really desperate - but it is essential to express as often as the baby would feed, so you stay comfortable and so milk continues to be produced....if this is done your baby will not need formula as the expressed milk will be there

Air drying the nipples, with or without milk on them, hasn't been recommended for some years now; the principle behind what seems to be the most effective healing is moist wound healing which prevents a scab forming (air drying promotes scabbing, which is not helpful). You can buy branded lotions that use this principle specially for nipples.

I had terrible cracked and bleeding nipples when I first started feeding DD. I used nipple shields for a week to allow my nipples to heal. I know nipple shields are sometimes viewed as the work of the devil (I'm not sure why?) but they worked for me. The alternative was to stop bf as I was in so much agony! Im still bf DD 11 months on.

Tiktok - I actually read about the breastmilk on the nipple in LLL Womanly art of breastfeeding (current edition) - and I have heard it recommended quite a lot and it certainly worked for me - although I know this is anecdotal! I know moist wound healing is recommended (hence lansinoh! )but my understanding of 'drying' was using heat to dry them - which is no longer a suggested treatment. I didn't think there was anything wrong with just 'airing' them - the reason I suggested it was because I hated the feeling of a bra or clothing against my cracked nipple and it felt much nicer for them just to be bare

Brownster, I so feel for you, my first eight weeks were hell, all the same as you, and a couple of doses of mastitus (sp?) as well. It was torture, but i was determined.

I had a BFC call to the house and guide me through. She showed me how to feed lying down and it really changed things for me.

Letting them air dry also helped the healing, and that means hanging around the house all day with them out, not just 10mins!. But mine (both nipples) were so bad i also resorted to a nipple sheild, and that too was a lifesaver for me. It was either that or give up.

It really does get better, and then it becomes great. I fed my DD until she was 14 months and i'm so glad i persevered.

Your doing great. I hope they heal soon. Good luck.

Sorry - just checked LLL international website and putting expressed milk on the nipple isn't recommended if you have thrush (although still is otherwise ) so if you are still being treated for thrush at the moment then it isn't a good idea - sorry! Other useful tips can be found here

bubbley - I can't check the Womanly Art at present, but I would be really surprised if LLL are still recommending air drying. There's nothing on the LLL website to suggest that is a good idea, and they reference moist wound healing as effective which is the opposite of air drying.

I know it is still recommended a lot, but to be honest, it shouldn't be....avoiding clothing rubbing against already damaged skin is a different thing.

Hi tiktok - the link above is to the llli website - and it mentions using breastmilk (although not if you have thrush - hence my correction above! ) Allowing them to 'air' is based on my own experience of not wanting anything against them - although, as I said, I didn't consider this to be 'drying' them because I wasn't applying any heat - it was just more comfortable. LLLI doesn't say anything against air 'drying' - just using heat to dry them.

hi tiktok, i just checked the womanly art, and you are right, they recommend moist wound healing, and suggest lansinoh -

"pat nipples dry after feeding and use a pea-sized portion of lansinoh and apply to each nipple. gently pat it on, do not rub it in"

also, dont use soap on your nipples, because this will further dry them out.

'Air drying' doesn't mean 'allowing nipples and breasts to be exposed to the air'....it means drying them in the air ie they have to be damp or wet first

It's not recommended, because of the need for moist wound healing. And I'm glad to see LLL don't recommend it, either.

Glad we have got that cleared up

Is it worth giving Silverette a go? They are still half price at breastfeedingheaven and come recommended by MNers

Hi Brownster,

I gave up BFing this week and my little boy is 9 months old. I say that to encourage you as we found it SUCH a struggle for the first couple of months - so painful and I had the bleeding cracked nipples too.

what kept me going:

*Lanisoh smothered all over them, to be honest as much as I could get on them I used! Definitely not air drying - that just dries the skin out which cracks it more.

*I expressed for the 10:30pm feed, which meant my boobs got a break from 7pm till either the middle of the night, or eventually till 7am, depending on how big your LO is. Eventually I did formula in the middle of the night too (ready made carton by your bed) so my boobs typically got 12 hours break each 24 hours.

*Once eveyr few weeks when they were getting bad again, I expressed for a whole day, then started up again.

Everyone's different but like I say, I had no supply problems and that's what kept me sane and going, and we got to nine months! That said, if you stop, know that you've done the very best you can and you've given her the best start you could - well done

Really really REALLY best of luck to you. Take care xxx

yes rest them let them heal and then try and go back to it, i rested mine for a day , the milk did not vanish and then i had the rest from pain to carry on and still am 6months later, how can you and baby enjoy feeding like this you are doing well but i tell you formula or ebm won't make the world end , but might let your nipples heal.

if you express your milk won't vanish and it might stop it getting any worse.

Red, just wanted to clear up - I didn;t say Tiktok was wrong I know moist wound healing is recommended by LLL - but so is breastmilk - as another option. Also, there was obviously a bit of confusion about what consituted as air-drying but we've cleared that up - obviously anything 'drying' isn't good but letting the air get around them isn't a problem! Not arguing with Tiktok at all!

Straight from the LLLI website - advising on the treatment of sore nipples.

In general, thrush thrives on milk and moisture so your nipples should be kept dry. Try rinsing them with water and letting them air dry after each feeding.

This is why I didn't feel that air was considered 'drying' - just heat.

Thank you so much to everyone for all the good wishes and advice , it does help to know that others have been through the same thing. Am trying to express enough to feed only breast milk but am only getting about 50ml from each breast at any one sitting, which my little greedy guts gulps in a minute, bless. Will keep on trucking I suppose, though am beginning to feel like a cow . If I do give her a bit of formula I won't feel quite so guilty and evil now.

sorry to pursue the 'airdrying' issue but in this case, since the OP has fairly massive nipple damage, the key issue is to treat both at the same time and since thrush can be treated systemically with fluconazole and at the skin level with Daktarin or similar, a bit of dampness isn't going to make a big difference to treatment IMHO.

Yet any scabbing over could make a difference to the healing of the cracks. So my suggestion (only from personal experience of this with all 3 babies, lots of research and experimentation etc - am not a BFC) is to get urgent systemic treatment for the thrush, and to comprehensively address the cracks with moist healing (Lanolin cream as suggested, and/or something like moist gauze dressing between feeds - Jelonet is what I was recommended and works a treat. You can buy it from the pharmacy counter or your HV might be able to get some for you. This was good stuff as even Lansinoh dries up and sticks to a breastpad after a while)

I think you simultaneously need to think about the source of the cracking - you need to get a good BF counsellor to see what you're doing and help with positioning...

Perhaps if there were no cracking, the LLL approach might be right but in this situation, there are 3 different issues to deal with.

Willself I agree - I am dealing with cracked nipples and thrush all at once at the moment.

I am taking fluconazole - OP not sure if this is what you are getting - if it isn't then get thee back to your GP I have been taking it for 9 days so far and have another 8 days to take after reviewing with my GP yesterday.

I'm also using Lansinoh or Kamillosan (sp?) on my nips to deal with the cracking as I've had a recurring mastitis which has been caused by the cracking. I have been advised to keep my nipples moist to allow healing and let the fluconazole deal with the thrush. So far this seems to be working and the cracking is almost gone, and the pain from the thrush is reducing day by day.

brownster you have my utmost sympathy as the pain of the two combined is hideous. Are you taking paracetamol, it does take the edge off for me at least!

Thanks again, have been absent for a few days as to top it all off i have had a nasty case of mastitis and have been really poorly. I just don't know if i'm coming or going. I've been taking the fluconazole and have had canesten cream for the thrush, DD has had drops, and have been taking paracetamol and ibuprofen for the pain. As well as this iv'e been applying the lanolin stuff for the cracks, and have been using hot baths, combing, massage, cabbage leaves and expressing for the mastitis. The doc has now given me antibiotics as the infection is now over half of my breast, which believe me is a large surface area, so we can prob expect a repeat of the thrush. After all that I am exhausted and in lots of pain, needless to say DD has been having some formula as I wasn't physically able to feed her. Am going to speak to a BF specialist from the local hospital in a last ditch attempt to salvage the situation, positioning prob is DD will not open her mouth wide enough and dangles on the end of my nipple, any tips?????

I had similar positioning problems and a bad case of mastitis with my first and ended up giving up after 10 weeks, which I hated.
This time I went to the local BF group. They had a DVD from Australia, which had a really helpful part on latching on. The lady demonstrating was pulling slightly on one side of her breast to make the nipple tilt towards the baby's top lip, so that when the baby did open up he could get a really good mouthful in the right position. It was almost like she was flicking the nipple in (how do they make it look so easy?) I tried this with my daughter a few times till we got the knack and it seemed to work. The idea is that the nipple is not being rubbed by the hard pallet, but is further back by the soft pallet and then there is less friction.
I agree with the others here who suggested Lansinoh - it worked well for me.
I hope this helps and good luck

Brownster I don't have any pearls of wisdom for you but feel compelled to say a big well done for bearing with bf when you have been really up against it.

I too had loads of problems at the start so know how truly crapola it can be - you are a star for persevering!

I got help from my local infant feeding team at the hospital - they were brilliant and got me through to the other side. I truly hope you get sorted too. xx