Help-Cracked nipples for 4 months now!

[manyblessings]

Ok, I am not sure if anyone has had this happen before. I have BF my first 4 children with no major problems and was still until recently BF'ng DS #5. I found out I was pregnant with #6 at the end of March when DS #5 turned 1. I continued to BF him as I have with all my other children even while I was PG. Well, my nipples started to crack and bleed and after about 2 months of pain every time he nursed and my nipples still not healing I decided to wean him at 14 months. I nursed my first 3 DD's for 13 months and my 4th DS for 22 months so I was REALLY sad to wean him. Now, with no nursing at all for the last two months my nipples are STILL cracked and raw. I have used Lanolin faithfully, Pure Vitamin E, olive oil, sleep topless and still not healed! I am beginning to worry that I won't be able to BF the new baby DUE 12/05/07. It seems like my nipples are permanently damaged. Anyone have any suggestions ?

[hapaness]

I had horribly cracked nipples with my last ds...I tried this and it was wonderful. Go to a lactation consultant or your OB and ask them to write you a prescription or make some yourself with polysporin, hydrocortisone, and some sort of yeast infection cream like miconizole.

Jack Newman's APNO

1. "All purpose nipple ointment" (APNO)

This combination of 3 ingredients seems to help for many causes of sore nipples, including poor latch, Candida (yeast), dermatologic conditions, infections of the nipple with bacteria and possibly other causes as well. It is always good, however, to try to assure the best latch possible, because improving the latch helps with any cause of pain.

*
mupirocin 2% ointment (not cream): 15 grams
*
betamethasone 0.1% ointment (not cream): 15 grams.
If betamethasone ointment is unavailable, mometasone ointment (15 grams) can be used instead. It is better not to mix creams and ointments.

To which is added miconazole powder so that the final concentration is 2% miconazole. Sometimes it is helpful to add ibuprofen powder as well, so that the final concentration of ibuprofen is 2%.

This combination gives a total volume of approximately 30 grams. Clotrimazole powder to a final concentration of 2% may be substituted if miconazole powder is unavailable, but both exist (the pharmacist may have to order it in). I believe clotrimazole is not as good as miconazole, but I have no proof of that. Using powder gives a better concentration of antifungal agent (miconazole or clotrimazole) and the concentrations of the mupirocin and betamethasone remain higher.

The combination is applied sparingly after each feeding (except the feeding when the mother uses gentian violet). Do not wash or wipe it off, even if the pharmacist asks you to. In Canada, Kenacomb (easier to find) or Viaderm KC (less expensive) ointments (not cream) can be substituted for the above combination, but are distinctly inferior. I used to use nystatin ointment or miconazole cream (15 grams) as part of the mixture, and these work well, but I believe the use of powdered miconazole (or clotrimazole powder) gives better results.

Any pharmacist should be able to make up this ointment, but not all want to. Not all pharmacies carry all the ingredients. If you are having difficulties, ask the pharmacist for the nearest compounding pharmacy.

[manyblessings]

Ok, latch is not the problem because I am no longer nursing.

And, what is a compounding Pharmacy?

[S Starr]

Ooooh, I'm so sorry for you, Mama! Do try yeast infection remedies; you might ask about an oral yeast med as well as creams. I'm not sure what you can take during pregnancy. I also used gentian violet on my nipples when I had a yeast infection. (while b******; dd got a purple face from nursing!) And I've found that a soft sports bra at night feels way better than going topless. I don't know if it helps for healing, but my all-time favorite soothing tool when my nipples were cracked was Soothies gel pads. Expensive, but if you're not leaking they'll last for 3-6 days/pair, and they feel soooo nice. Heal soon!
Sarah

[manyblessings]

Where do you get Gentian Violet? I've heard of it before, but I have not found it at my local health food store.

[S Starr]

I did find it at a health food store. If you can talk to a local lactation consultant, she'll probably know where it is in your area. Good luck!

[hapaness]

Originally Posted by mom2five Where do you get Gentian Violet? I've heard of it before, but I have not found it at my local health food store.

As far as a compounding pharmacy goes...I have no idea what it is but if you ask your pharmacist, they could tell you.
You can also find Gentian Violet at a pharmacy like Walgreens or Longs Drugs. I used that too but its SO messy...everything was purple! LOL

[archerneleri]

that definitely sounds like a major yeast problem you need to take probiotics interally or it's going to keep coming back. just treating on the surface with help you feel better for a little while. you really want to get this under control before the new baby gets here or you'll be dealing with some terrible thrush good luck! yeast is the pits, i'm dealing with it right now too, nursing HURTS so bad on top of the normal pregnancy pain.

[2babiesndiaps]

I have had thrush a ton and totally swear by Gentian Violet, so warning this is going to be a long response! LOL

Originally Posted by mom2five And, what is a compounding Pharmacy?

A compounding pharmacy is where they will mix up different ingredients according to the doctors specifics. Not all pharmacy's do this even though the could because the pharmacists are trained in it, but I think it has something to do with insurance. You can ask at a regular pharmacy if they do or who does. They will know. Usually it's not close, but it can be worth the hassle

Originally Posted by mom2five Where do you get Gentian Violet? I've heard of it before, but I have not found it at my local health food store.

I found it at my Grocery store pharmacy and also at one Walmart pharmacy. Start calling around. They will probably ask you to spell it and have to check, and may have to order it. Every time I find some I buy it because it can be hard to find. It is reality inexpensive in the small bottle- 2.99. But I also bought a little bit bigger bottle for 13 which I thought was pricey but bought it cause I needed it.

Originally Posted by hapaness You can also find Gentian Violet at a pharmacy like Walgreens or Longs Drugs. I used that too but its SO messy...everything was purple! LOL

It can be messy if you aren't used to it! You can apply it just before you take a shower and then you don't get anything else messy. Here's an email I wrote about it for someone else on how to keep it from being messy. I've got it down now where I don't have to take all the precautions to stay stain free! I think its mostly coordination!

For yeast rash, I always use Gentian Violet. It may take a few applications, but it works almost instantly. Gentian Violet is over the counter, but usually behind the pharmacy and the strongest anti fungal nature makes. It's usually under 5 dollars. I use a qtip to apply it. It will dry up the yeast before your eyes on a baby's bottom. They will look like dried up acne after you apply it.It does stain, so I'm not sure if you want to use some old diapers or go disposable for a few diaps until it won't rub off.Also you probably want to cover the bathroom floor in paper towels or old towels you don't care about. Usually Oxyclean at its strongest will get it out of towels, but sometimes not. Bleach gets the stain off porcelain (tubs and sinks and such) and nail polish remover will get it off your hands with a little bit of rubbing. Good luck. It's quite a challenge! We had yeast/ thrush for 2 months before hey diagnosed it and then for another month because we went with the Nyastatin and not the gentian violet right away!