WTF is happening with my right nipple???

[whitney4126]

LO turned 5 months yesterday and is EBFed.  My right nipple has been blistered and bloody for the past 10 days, like it was during her first month of life when she had a tongue tie.  I thought we were over this since she has had a perfect latch since she was 6 weeks old.  Bear with the rant, but I am in pain and feel crazy because nothing is working and I cannot figure out exactly what is happening.

About a week and a half ago, she randomly decided to bear down on my right nipple twice in one day, and then that night when we were both half asleep, she didn't have a good latch on the same one.  As a result, I got a blister.  Ever since, she doesn't seem to be able to latch correctly on that breast about 75% of the time.  But, it is difficult to tell because normally I know the difference between good and bad latch by how it feels, but the nipple is so sore right now, that I think even a good latch hurts in the beginning.  Also, she has become more distractible over the last month, and occasionally likes to jerk away with my nipple still in her mouth.  I am treating the nipple in between feedings/pumpings, and doing all the things I have learned to help with distracted feedings (feeding in a dark, quiet place, holding the breast in her mouth, etc), and I've even tried different nursing positions, but it seems like the nipple starts to heal slightly while I'm at work and pumping each day, and then by the morning time (after an evening and night of feeding), the wounds are re-opened and it is bloody again.  Yesterday I noticed her first tooth has just broken the surface.  I don't know if this has anything to do with it, but I don't know why it should just be an issue with one breast.  At one point early on, when I was dealing with really bad latch issues and my nipples were so painful, my LC suggested that I take 1-2 days and just feed on the good breast, and pump on the bad one, to let it heal.  I have thought about doing that, but ever since I started working and pumping 3 times a day last month, I am struggling with my milk not letting down for the pump.  Last Saturday, the baby slept a longer stretch than normal and I woke up in pain, so I tried to pump.  I pumped for 30 minutes and nothing came out and they were still like rocks, so I had to wake the baby up to get some relief.

I'm not sure what to do, other than what I have been doing.  I feel like I'm crazy because I don't know why this is only happening with one breast, and I don't know what to do.  After going through so much in the first 6 weeks, I thought I knew how to diagnose deal with any latch issues, and I thought they were over.  I am desperate for some healing.  So, I guess I am posting in the hopes that someone will think of something I haven't, as to why this is happening or what I can do to heal.  Breastfeeding had gotten so easy, and I loved it.  Now I am finding myself dreading every feeding, which I hate since that time had been so much more special since I started back to work.  I would appreciate any feedback, and if you have none, it's nice to just vent.

[rayray007]

Could LO have an ear infection or something that makes it uncomfortable to nurse on the one side?

[ashanne88]

Have you talked to a LC? If not, I would see if you can talk to one on the phone or, even better, go in so they can confirm that the latch is good and that is not the problem.

When I am really full I also have a terrible time getting a let down. If you're not already doing so, I've found that compressions are really helpful in getting the milk to start coming out. One thing to try is to self-express (no pump) to get some going and then try pumping. Also, make sure you're not on the highest setting on your pump. Have you tried looking at pictures of videos of LO when you're pumping? Some women find that really helpful for getting a let down. What helps me is to distract myself so I can relax better - read a book, watch tv, play a game, etc. Otherwise I sit and stress about how I'm not getting any milk which makes me really tense and more stressed and not respond well to the pump. Sorry I don't have a lot of advice for the blister but hopefully this will give you some ideas to try during pumping while it heals.

Sorry you're dealing with this! I hope you feel better soon.

[ellabee]

I don't really have any suggestions, because it sounds like you're doing everything I would recommend. But I just wanted to say I'm sorry you're going through this. I can only imagine the frustration of the situation and having to deal with latch and nipple issues this far into your nursing relationship. I hope you're able to work something out and heal soon. ::Hugs!::

[AmyRI]

Are you having any stinging pain during letdown when you pump and/or nurse? Any white spots in your LO's mouth? Nipple damage that doesn't heal might be thrush (a yeast infection of the nipple). I would expect that you'd see symptoms on the other side by now, though.

Re: pumping output - what kind of pump are you using? If you're using a Medela Pump In Style, have you changed the membranes (little white flaps) recently? That can really affect suction level. (If you're using an Ameda Purely Yours, the white rubber part is called a valve, but it needs to be replaced regularly as well.) It's normal to respond less well to the pump over time, but when you're engorged you should still be getting something and it sounds like a pump issue not a breast response issue. Also, try pumping one side while you nurse on the other side. Baby will trigger the letdown for you and help your pump output on the pumped side.

[whitney4126]

No stinging or white spots. As far as let down, I have changed membranes, checked flange sizes, done breast compressions, and tried thinking about the baby and not thinking about the baby. Sometimes one of those things will work, sometimes it won't, and sometimes it lets down just normal. One thing I have never done though is feed on one side and pump on the other simultaneously, so I might try that. I would just like to get the nipple issue resolved because I hate pumping when I don't have to. I worked with a LC a lot early on, but I haven't talked to anyone about this issue. There is a latch clinic that is much cheaper than a one-on-one session. If I am able to take off work early tomorrow, I may go.

[Deleted]

Most likely it stems from an altered latch from teething. If you can get help in person to check that it should help. Model opening wide when latching. They always latch a bit differently on each side, and that may just be the not so good latch side usually, but you did'nt notice it much til you got an injury.

try a totally different position on that side. warm water soaks speed healing, cool compresses and motrin for pain and inflammation. bacitracin on the tip of the nip covered with a non-stick dressing.

Taking some time off that side, pumping instead even if it's every other feed even for 24 hours instead of nursing might speed the healing if the latch is damaging things.

To help with let down, put a warmed rice sock in your bra. undo bra flaps and let the boobahs hang down, give em a bit of a shake, massage and compressions while pumping. make sure flanges/horns are the right size. look at pictures, videos, sounds of baby crying to help trigger let down--you want a bit of an emotional response, so smell of baby soap, play with a baby bootie might help as well.

OR some will let down better if they have pump anxiety by covering the pump with a towel and reading a non-mom/baby book or magazine, or watching tv, just checking occassionally to see what is going on.

Don't turn suction up too high, be sure it's high enough to pull milk but not high enough to collapse milk duct. play with the settings. If you can get an LC to check out your pumping, they may also have some suggestions.

Sometimes it helps to train your body to let down for the pump if you latch baby on one side and try pumping the other side at the same time or shortly after nursing. so baby signals the let down process which occurs on both sides at the same time. you may also be able to cue it with a sound, video, song, smell, pic at the same time. so if you are away from baby you can use the sound, video, song, smell, pic to help trigger let down.
once you get let down, pump for 5-15 minutes after milk stops flowing, playing with the pump settings for speed and suction to try to trigger another let down.

[whitney4126]

Feb 11, 2015 14:47:10 GMT -5 @amyg said:

Most likely it stems from an altered latch from teething. If you can get help in person to check that it should help. Model opening wide when latching. They always latch a bit differently on each side, and that may just be the not so good latch side usually, but you did'nt notice it much til you got an injury.

This makes sense!  Thank you!  I always enjoy all your suggestions, but this specifically makes me feel less crazy to think theres an actual explanation for the sudden change on one side.