Painful Nipple

V.:

call a lactation consultant to help you... pain means something is wrong and you need someone to help sort out what is causing the pain. help with a solutions and help you move forward so this does not repeat.

P., RLC, IBCLC
Internationally Board Certified Lactation Consultant
Breastfeeding and Parenting Solutions
www.breastfeedingandparentingsolutions.com

Definitely seek help as others have suggested.

BUT if nursing continues to be so difficult, you should congratulate yourself for sacrificing so much for your little one and you may want to consider switching to all formula. I know everyone talks about how wonderful breastfeeding is, but the reality is that there is a small percentage of women that can not do it. It can be extremely isolating and traumatic, but your baby needs a happy and healthy mother. Your son has already had the awesome benefit of five months of breastmilk! My sister finally came to the very difficult decision that she could no longer nurse after a few very painful months. At first, she was devastated, but she soon realized there are many women out there that have difficulties nursing, but that is a hard thing to admit in the current climate! Now her two boys are 4 and 2 and extremely happy and healthy. Remember, an entire generation of children were raised on formula in the fifties!

Really, be good to yourself and your child -- don't feel guilty for a second and switch to formula if that is what works!

Hi V., warm wash cloths on the area my help, too. Try to hand pump on that breast without the baby nursing until the nipple is healed. The warm compresses may help if your breast is sore or has hard spots, and may help the nipple heal. Keep some balm on it like Neosporin until it heals. After the scabbing heals, then start him nursing again. You'll want to pump in the meantime to keep milk in production from that breast.

It should have healed by now, even if he is nursing on it. What is probably happening is that the reason you got the sore to begin with (improper latch) is still occurring. I am a mom of three and nursed them all, and unfortunately for every single one of them nursing was difficult due to my nipple shape and their latch. Is the scab right on the top of your nipple? He could be compressing his upper lip around the area rather than allowing his lip to open up, this will cause a repeated sore area right on the top end of your nipple. There are free lactation consultants at hospitals, you can call and get some advice. I had this problem. I would slide my pinkie gently under their upper lip and "unfold" it around my nipple as they were nursing. They eventually started to latch properly on their own.

Not sure if you work or what, but improper latching leads to dysfunctional milk production (and also it hurts like heck, so who wants to nurse), and a viscious cycle of not being able to keep up milk supply. Good luck, nursing may be natural, but its not always easy!

I swear by Lansinoh. It's a natural ointment that you can put on your nipples and is safe for baby. Any drug store sells it in the baby/breastfeeding area (where they sell nursing pads, bottles, etc.). You should find that nursing more than 2 times a day is possible after using Lansinoh. If you have more questions, call the lactation center at your local hospital.

Also, CNN just reported the following about another nipple cream. Don't use this one:

WASHINGTON (AP) -- The Food and Drug Administration on Friday warned women not to use or purchase Mommy's Bliss Nipple Cream, marketed by MOM Enterprises Inc. of San Rafael, California.

The cream, promoted to nursing mothers to help soothe dry or cracked nipples, contains ingredients that may cause respiratory distress, vomiting and diarrhea in infants, the agency said.

The potentially harmful ingredients in the cream are chlorphenesin and phenoxyethanol.

"FDA is particularly concerned that nursing infants are being unwittingly exposed by their mothers to this product with dangerous side effects," said Janet Woodcock, director of the Center for Drug Evaluation and Research. "Additionally, these two ingredients may interact with one another to further compound and increase the risk of respiratory depression in nursing infants."

The company has stopped selling the cream. The FDA said consumers should stop using the cream and consult a doctor if they experience problems or believe that their infant may have experienced problems due to the product.

Mothers whose children may have suffered adverse effects because of this product should contact the FDA's MedWatch at 800-332-1088

If it is that painful maybe you should see your doctor. They could give you some advice. Also could be something that requires meds.

HTH

I had symptoms similar to what you describe when my son was about 10 mos. It turned out to be thrush. I also thought it was an injury that just wouldn't heal (my son was cutting teeth and I thought he had bitten me). Go to the dr. and have them check it out. If it is thrush, tell them to give you the rinse to treat the baby's mouth as well as the cream for your breast. It could save you a second trip to the dr. Also, buy some disposable breast pads and put a clean one on your breast each time to put on more cream. It will save you from having to continually change and wash your bras. I only had a few nursing bras so doing that saved me from having to wash my bras every day. I also kept using the cream for longer than they prescribed -- my dr said use it for two weeks, but the thrush kept coming back so I used it continually for a month even after my symptoms had subsided and it finally went away. Good luck!

Well having had experienced some discomfort during breastfeeding I did not necessarily have clogged milk ducts. It also sounds like your nipples have been effected not so much the duct inside your breast. My suggestion to you off the top of my head would be to go to your local Whole Foods or natural baby store and buy a nipple cream that is safe to use and does not need to be washed off before breastfeeding. Also there is a brand called Lansinoh and it works great. I would also get in touch with your local LaLeche League which will put you in touch with many nursing mom's in your area. This can help in any other problems that may come up. I hope that helps and please don't stop breastfeeding it is so important for your baby and you. I breastfed my son for three years (he is 5 1/2 now) and he is the happiest healthiest child I know!

My girlfriend just went through something similar and it turned out that her son had thrush and was passing it to her breast while nursing. She was in excrutiating pain and thought the same thing as you - just a clogged milk duct. She was pumping all the time to try and give her nipple time to heal, but as soon as he latched on again she was in agony. When she finally couldn't take it anymore, she saw her doctor and got the diagnosis - a week and some antibiotics later, both are much happier! It might be worth looking into...

Hello V., have you tried a hot to warm compress on your breast? If not try that, I had a heck of a hard time getting all of my milk to come in and "free flowwing" that I was told to try that....it worked great, when it looked like it was going to explode sort of speak try to lightly squeeze it to relieve the pressure of the blockage. Good luck.

I had something like that and so pumped for a few days until it healed.

I don't want to worry you, but please read the following email. Sorry it's so long, but it's important.

New kind of Breast Cancer

Please forward to all of the women in your lives ............ Mothers, daughters, sisters, aunts, friends, etc.

In November, a rare kind of breast cancer was found. A lady developed a rash on her breast, similar to that of young mothers who are nursing.
Because her mammogram had been clear, the doctor treated her with antibiotics for infections. After 2 rounds, it continued to get worse, so her doctor sent her for another mammogram. This time it showed a mass.
A biopsy found a fast growing malignancy. Chemo was started in order to shrink the growth; then a mastectomy was performed; then a full round of Chemo; then radiation. After about 9 months of intense treatment, she was given a clean bill of health.
She had one year of living each day to its fullest. Then the cancer returned to the liver area. She took 4 treatments and decided that she wanted quality of life, not the after effects of Chemo. She had 5 great months and she planned each detail of the final days. After a few days of needing morphine, she died. She left this message to be delivered to women everywhere:

Women, PLEASE be alert to anything that is not normal, and be persistent in getting help as soon as possible.

Paget's Disease: This is a rare form of breast cancer, and is on the outside of the breast, on the nipple and aureole. It appeared as a rash, which later became a lesion with a crusty outer edge. I would not have ever suspected it to be breast cancer but it was. My nipple never seemed any different to me, but the rash bothered me, so I went to the doctor for that. Sometimes, it itched and was sore, but other than that it didn't bother me. It was just ugly and a nuisance, and could not be cleared up with all the creams prescribed by my doctor and dermatologist for the dermatitis on my eyes just prior to this outbreak. They seemed a little concerned but did not warn me it could be cancerous.
Now, I suspect not many women out there know a lesion or rash on the nipple or aureole can be breast cancer. (Mine started out as a single red pimple on the aureole. One of the biggest problems with Paget's disease of the nipple is that the symptoms appear to be harmless. It is frequently thought to be a skin inflammation or infection, leading to unfortunate delays in detection and care.) What are the symptoms?

1. A persistent redness, oozing, and crusting of your nipple causing it to itch and burn (As I stated, mine did not itch or burn much, and had no oozing I was aware of, but it did have a crust along the outer edge on one side.)

2. A sore on your nipple that will not heal. (Mine was on the aureole area with a whitish thick looking area in center of nipple).

3. Usually only one nipple is effected. How is it diagnosed? Your doctor will do a physical exam and should suggest having a mammogram of both breasts, done immediately. Even though the redness, oozing and crusting closely resemble dermatitis (inflammation of the skin), your doctor should suspect cancer if the sore is only on one breast. Your doctor should order a biopsy of your sore to confirm what is going on.

This message should be taken seriously and passed on to as many of your relatives and friends as possible; it could save someone's life.

My breast cancer has spread and metastasized to my bones after receiving mega doses of chemotherapy, 28 treatments of radiation and taking Tamaxofin. If this had been diagnosed as breast cancer in the beginning, perhaps it would not have spread...

TO ALL READERS:

This is sad as women are not aware of Paget's disease. If, by passing this around on the e-mail, we can make others aware of it and its potential danger, we are helping women everywhere.

Please, if you can, take a moment to forward this message to as many people as possible, especially to your family and friends. It only takes a moment, yet the results could save a life.

What everyone else said -- something's not right, and you need a professional to find out what it is.

You can also use olive oil as a moisturizer/nipple cream. The other ones (esp. Lansinoh) didn't work for me, and the dermatologist I saw for my "macerated" (a.k.a. "shredded") nipples said olive oil would be just fine if not better.

Also, there is nothing to feel guilty about. You're doing your best!

I had deep cracks when I first started nursing. My lactation consultant had me pump for 24-48 hours to heal, and she also prescribed what she called a triple ointment that had antibiotic,cortisone, and anti-fungal in one. I would put it on between nursings and wipe it off just before. It helped immensely. I would suggest seeing your doctor or a lactation consultant. Hang in there, I know how hard it can be!

i had pain for other reason but my nipple was bleeding and i tried to just pump on that one and nurse on the other for 2 days or so and it got better. not sure if that would help you or not

I also swear by Lansinoh. After a rough start with my first, a lactation consultant turned me on to the ointment. When I was due with my second, I was sure to have my Lansinoh ready. The soreness disappeared, and the babies didn't mind it. It's a really fast healer, just keep the stuff on constantly, wipe off the excess before baby latches on, then slather it on again and use a nursing pad. Good luck.

I had wounds when I first started nursing, and I was told not to let it scab over, contrary to what you would think for most wound healing. I used what they called a triple nipple compound which helps heal the wound and provides some pain relief, and you don't have to worry about wiping it off before the next nursing (though you usually apply it after a nursing session). I think it's the same as Dr. Jack Newman's nipple ointment. Most doctors have heard of it and can write a prescription for it to be compounded at a pharmacy. Another good topical nipple cream that is safe (i.e. you don't have to wipe it off for nursing) is made by Motherlove. Their products are at Whole Foods (usually near the vitamins). I think if you let it scab over it will only continue to hurt when your baby nurses. If you want any other advice or more info about the triple ointment you can call The Art of Breastfeeding at ###-###-####. I think they have a website too. They're a really wonderful resource.

ok, i apologize for all of the questions, but i'm not sure exactly what you are saying... why do you think it is a plugged milk duct? this would feel like a lump in your your breast, be tender to the touch and probably enflamed. if it had been going on for 2 months, chances are that you would also have a fever and further infection.
do you have pain in both breasts when your son nurses? or just on the side with the scab? if you have pain in both breasts when he nurses, i would suggest having his latch evaluated as that pain can be excruciating and can linger after the nursing session is over. if the pain is only on the side with the scab, i would look into why the crack has not healed as well as evaluating his latch on that breast.
is the scab on the tip of your nipple? if so, it could be that you have a cracked nipple from a problematic latch. the best healing is air and lansinoh. let your nipple dry (no bra whenever possible, or cotton bra, or let the nipple air dry before closing your bra) adn then apply the lansinoh to the scab. if it is a crack, nursing would hurt a bit - like touching a cut anywhere else on your body - but it should stop hurting once baby stops nursing. since you say that the pain continues AFTER he's done nursing, where does it hurt? is it a local, nipple only pain right around the scab? or does it make your whole breast hurt? does it ooze (life it's infected) or hurt even when baby is not nursing? if it is making your whole breast hurt, or seems to otherwise be infected, and because it hasn't healed for two months, i would suggest contacting your local LLL group and going to see a leader about what else it could be. breastmilk is amazing stuff and actually helps cracks heal when allowed to dry. if it is some kind of plugged duct, the scab would be sort odd, which makes me think it is some other kind of infection or something else.
i'm sorry this got so long!

oh! and WAY TO GO MAMA on nursing for 2 months on a hurt breast, and for sticking with it even with other difficulties!! There should be more of you out there!!

Get in touch with your local La Leche League! A leader would be happy to talk to you and help you work through your problems. Info online at www.llli.org

Have you been to your Dr? Nothing should take 2 months to heal, even with the scab being pulled off repeatedly.
Honestly, it does not sound like a clogged or healing milk duct. Your milk ducts are higher up in your breast tissue & some are even under your arms. Did you or the baby have thrush? It's a yeast infection that babies can get in their mouths. You may notice a white film on his tongue, gums, cheeks, & roof of mouth. If that is the case, you need to go to the pediatrician (or call it in to them) and they'll prescribe a liquid that you have to paint the inside of his mouth with. You also can paint yourself with it. If that's the problem, this will clear up the infection & allow you to heal.
If that is NOT the issue, I'd try changing nursing positions on that side to change the angle of his latching on. Laying down side by side, reverse him & use the football hold (pillows help to support him with this one), anything at all to change the angle.
But first off, you REALLY should go to the Dr & have them look at it. Your OB/GYN would probably be the best one to see.
Good luck, hope this helps!
Starlite *

Have you contacted your doctor or a lactation consultant? That would be my first suggest just to make sure that there is not more problems going on then a sore nipple. I had a similiar experience, although 'chunks' were missing from my nipple - talk about painful. So, I can relate to the pain factor. The lactation consultant that I saw told me to pump and feed my daughter with a bottle until I healed. This way she was still getting the breastmilk like I wanted and I wasn't in so much pain each feeding. You can also try expressing some of your milk onto the sore nipple and letting it air dry. The antiboties in your milk have some type of healing in it, so that may help you also. Good luck!

V.,
It seems like you have gotten some wonderful advice. I had clogged ducts years ago and had no electric breast pump and no way to have access to one. I was advised to take very warm baths and fill the water as high as possible and to express the milk out in the water. This helped me when nothing else did. It came out as long stringy things, but it was such a relief. Another thing that I haven't seen suggested (maybe I just missed it) is to use a nipple guard on the painful side until it can heal. You don't need to buy anything special, you could just use a nipple from a bottle--just place it over your nipple. When your little guy latches on, it will form a suction and the milk will flow through the nipple. It might be worth a try. God bless you for bearing the pain for 2 months--you have nothing to make apologies about. I hope this helps. Good luck to you and your little guy!