Breastfeeding nipple torture after 10 weeks :-( please help!
March 6, 2018 12:33 AM   Subscribe

What is going wrong with my breastfeeding and what, if anything, can help?

I had my lovely little boy 10 weeks ago :-)
I suspect this isn't relevant to boobfeeding but it was a traumatic birth. In-spite of this knackering us both he took to the boob well.

The support I have had from our brilliant NHS has been exceptional.. but after all these weeks and being watched feeding by 3 Health Visitors (one a specialist and one a family member who sees us regularly), several midwives and visiting the GP back and forth I am still in pain.

There is some improvement in that I mostly don't scream through the ceiling when he latches on but I am often still so sore I dread him going on :-(.. there is a slight variation at times.. but I haven't noticed a particular pattern.

No one has noticed a latch problem (very occasionally we slip up, but this isn't the norm).
I have been treated with antibiotics for mastitis when I had an obvious dose and my boob got red and sore... I have taken Ibuprofen for inflammation (All Purpose Nipple Cream by Dr Newman is not recommended by the NHS due to it's steroid component and you can't get it here anyway.. I have wondered if I can somehow get it as have considered a bit of steroid might be less bad for baba than me giving up bf...?).
I now have Nystatin 'drops' (?). They are not drops! It is yellow glue that means I have to rip my sore nip from my clothes/sheets and even baba thus further traumatising the nip :(.

I have bathed my nip, soothed with cabbage leaves, nipple shields, different positions, expressed to take 2 days off. Everything helps a bit, for a while and I always use lanoline afterwards. I cannot think what else to try??

I have taken a multitude of painkillers.. which ain't great cos obviously he is getting all that too..

At first the pain was like my nipple was on fire... some subsidence when feeding but pain ever present. It is a slightly better version of this. It has consistently been much worse in my left nipple but right nipple can be bad too, which is fairly recent.. so has something transferred?
Bab's mouth is fine (no thrush) the doc's don't think I have it.
I always sometimes get a weird spiky shooting pain in my actual breast.
I know bf can be very tough and from what can gather fair skinned women seem particularly prone to this but everything says you turn a corner around 8 weeks.. this is one of the few things that's kept me going!!

I really don't want to give up for all the health benefits for baba.. especially as his daddy has a proneness o bad excema... I am determined to maintain a secure attachment and in spite of all the physical pain I do see the Oxytocin produced is protecting me from depression :) :) :)
which is a massive incentive for both of us to continue...

I'd be so grateful for any help or suggestions and can't believe how much I've just written about my nipples!
posted by tanktop to Health & Fitness (17 answers total) 3 users marked this as a favorite
 
My wife had vasospasm of the nipple and this sounds similar. In her case keeping the room (and the boob) warmer made a significant difference, although it wasn't a 100% cure.
posted by the duck by the oboe at 1:21 AM on March 6, 2018 [1 favorite]


It might be worth paying to see a lactation consultant. NHS supporters are great and totally saved my breastfeeding journey but several of my friends with more complex problems supplemented this with a private lactation consultant and found that very helpful. They should be an internationally board certified lactation consultant. It might also be worth being evaluated for tongue tie. In some places you can self refer, others need a referral from your health visitor. At 10 weeks you may have to travel to get seen in another area.

For the horrible experience of repeatedly ripping the tip of your nipple off try breast shells. They were amazing to let my nipples heal a little.

Finally, although you enjoy your NHS support I'm a believer in getting as many opinions as possible. One person may just say something that really helps. Try La Leche League support groups in your area, NCT support groups, the breastfeeding helpline. I know Facebook can be a minefield but there are some superb breastfeeding support groups with qualified admin. Mail me if you want details.

It can get better. I had a similar early experience and I'm still breastfeeding at 14 months. It took longer than 10 weeks to sort it out but it did get much, much easier.
posted by kadia_a at 1:54 AM on March 6, 2018 [9 favorites]


Chiming in to say that you need a lactation consultant. FWIW, I found Newman’s advice completely useless as a large breasted woman. Has anyone checked baby for tongue or lip ties?
posted by PorcineWithMe at 3:04 AM on March 6, 2018 [1 favorite]


Weird spiky shooting pain could be vasospasm or painful letdown. For me it was a tongue tie. I have a 10 week old as well, and my pain improved dramatically when we got a tongue tie clipped at 4 weeks. Because she couldn’t use her tongue properly, her only possible method of feeding was to pinch my nipple — no matter how great the latch looked! As my doula said, if you’re in pain then it’s not working.

I have found the KellyMom site very useful as we’ve tried to navigate this. Here’s a starting point for types of nipple pain.

I have also found the All Purpose Nipple Cream very helpful (Canadian midwives and lactation consultant prescribed it) but if your docs won’t prescribe it, google the DIY recipes. It’s a pretty basic thing that can help a lot with something that is causing real harm (versus the theoretical risk of steroids).

I also want to assure you that if this gets worse and you can’t continue breastfeeding, you can still have a secure attachment! Being a present, loving parent is all you need. Breastfeeding has a lot going for it but it’s just one of multiple great options open to you and your little one. When I was in pain every time she fed, I began to dread it. I tensed up. Sometimes I cried. Feeding her a bottle of expressed milk during that time was so much more relaxing and I could be much more present for her. Formula feeding would have given us this emotional space as well. You have options!
posted by sadmadglad at 5:02 AM on March 6, 2018 [5 favorites]


Some thoughts:

- Could you try using nipple shields? Yeah, I know they make sucking a bit harder for the baby, they're not "as good" as breast, etc etc, but I successfully breastfed my firstborn for 1 year (!) using nipple shields. (And 6 more months after that without the shields.)

- Maybe try pumping instead of BF for a few days, to let the nipples rest?

- In my case, "weird spiky shooting pain" in breasts means more milk is being produced. It usually starts some time after the last feeding session or when I hear the baby cry. YMMV.

- If the pain is so bad you start dreading the feeding sessions, it's much better for both you and the baby if you use pumped/expressed milk or formula and feed it to the baby completely relaxed and loving. Breasts aren't magic, parents' love and attention are!
posted by gakiko at 5:09 AM on March 6, 2018 [4 favorites]


Okay, so this may quite contradict what you've been told and have been reading about breastfeeding, but IT'S NORMAL FOR YOUR NIPPLES TO KEEP HURTING. Mine did, constantly, until about 4 months in by which time you could have hacked at my nipples with an ax and I would not have noticed. I breastfed two children for 20+ months each. This happened both times.

I hate telling you this, because of how it plays into the shitty narrative of "whelp we are women and therefore pain is normal." Also, your pain might be totally different from mine, which is why you definitely should keep reaching out to lactation consultants and follow other advice on this read. I'm just adding one little bit of anecdata. I lived with the pain until my nipples lost all feeling, and by any standard I was successful at breastfeeding (I even enjoyed it the second time around). YMMV.

PS: You don't HAVE to live with the pain or the inconvenience. Formula is awesome. You don't fail as a mother just because you decide that breastfeeding is bullshit. There are literally no experts in this world who can pick out the breastfed kids from the formula-fed ones from a lineup of second graders. Just saying!
posted by MiraK at 5:51 AM on March 6, 2018 [7 favorites]


You have my complete sympathy because I had the same experience. It hurt for a long time and there wasn't really any One Weird Trick that made it suddenly stop hurting, the pain just sort of slowly faded over time. This is, alas, fairly normal. The "if you're doing it right it shouldn't hurt" thing is hooey.

The vasospasm thing is definitely something to look into though. Keep a heating pad set on low, or a warm rice sock, or a hot water bottle near where you are nursing and warm your nipple up immediately before and after.

Have you been pumping at all? If not, see if that doesn't hurt as much and give baby a bottle of pumped milk as you can, just to give your nips a break.
posted by soren_lorensen at 6:23 AM on March 6, 2018 [1 favorite]


N'thing that this sounds very similar to vasospasm. Do you ever watch the color of your nipple while it's hurting? Periodic blanching (turning white) for a couple of seconds is the key sign there, IIRC. If it is vasospasm, then ongoing nipple trauma is what causes it, so definitely consider the possibility that the latch isn't as great as it may look from the outside, and ask a lactation consultant about the possibility of tongue-tie.

I'll also offer by way of random anecdata that what finally resolved my many months of issues with painful bf (+ visible vasospasm) was my doctor's randomly prescribing a metronidazole nipple cream. Before that I'd been firmly convinced that it couldn't be thrush because baby had no symptoms and neither did I, beyond the pain; but boy, that metro magically cleared everything up in under a week, to the point where even as the nipple would continue to vasospasm, I wouldn't feel any pain at all. So as you're working through the possibilities, maybe also be diligent about ruling out subclinical/asymptomatic thrush as a complicating factor on top of whatever else you've got going on.
posted by Bardolph at 6:30 AM on March 6, 2018


Chiming in with tongue tie. I had almost the same experience of burning pain and getting the tie snipped (sounds horrible but really wasnt) fixed it immediately.
posted by RandomInconsistencies at 7:02 AM on March 6, 2018 [3 favorites]


Do you have nipple blanching, and/or is your nipple shaped like a brand new lipstick following a feed? I agree with having your baby assessed for tongue/lip tie. Torticollis may also be present, given that one nipple is more affected than the other - babies with torticollis (wryneck) or "bodycollis" frequently have a different oral motor interaction feeding on different sides.

A multidisciplinary approach involving 1) a lactation consultant experienced in assessing and referring for tethered oral tissues, 2) an experienced bodyworker (you may be able to find someone in your area at Ankyloglossia Bodyworkers - UK listings are in the "International" section at the very bottom of the directory), and possibly 3) a qualified tongue tie revision provider may be helpful for you. You are doing a great job in a very hard situation.
posted by sutureselves at 8:25 AM on March 6, 2018


So sorry this has happened to you. It also happened to three young women in my close family, which I find strange because thirty years ago neither me nor my sister had this problem: everything calmed down about 6 weeks in.

So from observing my daughters and others I have 3 or 4 suggestions

1/ As people say above, have an expert assess your kid for tongue tie. In Bristol this happens as soon as there are problems at one maternity hospital but not at another.

2/ People will give you all sorts of remedies and suggestions. SOME OF THEM MAKE A PAINFUL SITUATION WORSE. Be very cautious and if your instincts are going 'Naaah!', don't be persuaded. Basically anything that's going to apply pressure or rubbing or extra handling to your nipples has the potential to hurt more.

3/ One of the young women I know was told about a technique called 'biological feeding.' Basically you get naked and lie down and let the baby crawl up the body and find the nipple themself. This is the only thing that worked for that particular mum, after weeks of searing pain. That is no guarantee it will work for you but if you can try it without hurting and without any extra wear and tear on the boobs, maybe give it a go.

4/ If you have to stop breastfeeding don't beat yourself up about it. Breastfeeding-equivalent milk is excellent stuff, better and safer than it's ever been. Do some research to find out the best human milk analogue: there are subtle differences in the way they are described that mean different things, sorry I can't remember the exact wording you should look for.

Best of luck and well done. It is hard, and there's no virtue in pain whatsoever. I hope you find a solution soon.
posted by glasseyes at 10:22 AM on March 6, 2018


Just chiming in to say I had a lot of pain initially with my now-16-week-old. Turns out he had both a tongue tie and an upper lip tie. It is definitely worth getting your kiddo assessed for that because we were both pretty miserable for awhile and my son wasn’t able to eat effectively from the breast. We ended up more or less exclusively pumping for probably 10-12 weeks (and supplementing with formula) because it just was not worth the stress to try to feed from the breast directly.

I also had the spiky breast pain between feedings which I think was my breasts making more milk, and a spiky nipple pain during and between feedings that turned out to be the feeling of my letdown. Both continued with pumping but got better gradually and are gone now.

We’re now weaning for unrelated reasons (suspected food allergies/intolerances) but comfort nursing when we want to (including right now!) and it’s lovely and no longer painful or frustrating. Pumping is mentally draining and especially hard if you don’t have help at home during the day, but it really helped us. Despite my occasional PPA-related worries, our attachment is lovely and plenty secure even with bottle (and formula!) feeding.

Good luck!
posted by bananacabana at 12:00 PM on March 6, 2018


Should have mentioned (sorry, mom brain) - we did have his lip and tongue tie revised but not till 10 or 12 weeks and by then bottle feeding was just easier for everyone, but I’ve heard from others who have had it make a huge, instant difference for feeding on the breast so totally worth considering.
posted by bananacabana at 12:08 PM on March 6, 2018


You need to see an IBCLC (lactation consultant). Nurses, midwives, GPs and randos on the internet are not qualified to help you - see an IBCLC, have them observe feedings, the whole shebang. (Sorry, but there is a lot of potentially harmful advice here.)

Of course you should also not feel ashamed if it doesn’t work out. But give it a try with an actual expert instead of grasping for straws. If the IBCLC can’t fix it, you can move to pumping or formula feeding and feel you gave it your best shot. Btw IBCLCs can also help you make that move and help you find a good routine!
posted by The Toad at 2:10 PM on March 6, 2018 [1 favorite]


I wouldn't rely on the NHS alone to help with the technicalities of breastfeeding. Midwives there have training (or lack thereof) all over the board. And the UK has something like the lowest BFing rate in the developed world. You can possibly even get a certified lactation consultant over Skype or something if you can't find many in the UK. Even then the lactation consultants vary in philosophy and quality.
In addition to lanolin, do you have access to organic nipple balms (not Dr. Newman's)? I used Boobease balm liberally in the first 3 weeks and it helped enormously. Also, please give your nips a break by pumping and/or using the plastic shells/shields that go over your nips and collect leaking milk at the same time or even using formula. In those first weeks, even soft cotton clothing brushing against your nips hurts a lot, so the plastic breast shields help a lot. In the first 2 weeks we used formula 60% of the time and that eventually decreased to 5% and now less once I learned how to use my electric breast pump and after my nips "hardened." My baby had zero "nipple confusion," and some are now skeptical that is even a real thing. In the first 3 weeks there was a searing, weird pain during every letdown, but that ended around week 4. Now there is zero pain even when my baby is tugging like a puppy or doesn't have the best latch. Good luck! I love BFing but it's okay to hate it, too.
posted by KatNips at 2:47 PM on March 6, 2018


Around that age, the last things that werestill making my nipples sore was baby's alignment. Are the ear, shoulder and hip all straight when baby is latched on?
posted by jillithd at 3:07 PM on March 6, 2018


My nipples hurt like fire with both my children. The only solution was lanolin. I used about ten times as much lanolin cream as anyone recommended. I mean I slathered that stuff on thick and didn’t worry too much about the baby eating some of it. They grew up healthy and did not baa, so no harm done. It took a while - 8 - 10 weeks sounds about right, you may be almost there - but eventually my boobs toughened up and all was well. I never pumped and they never would take a bottle or a pacifier either, so they were basically attached to the boob 24/7 for at least the first few months.
posted by mygothlaundry at 11:11 PM on March 6, 2018


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