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Old 12-17-2007, 07:57 PM   #1
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need advice and encouragement - very long

DD is now 3 1/2 weeks old, my first baby. I have been DETERMINED to breastfeed since before I was even pregnant. I attended breastfeeding classes and an LLL meeting before she was born, and began reading BFing books as soon as she was born. I expected problems, but I just wasn't sure which problems to expect. I apologize since this is going to be extremely long!

A history: DD BFed beautifully for her first 36 hours. Then, she fell asleep and would not wake up. The LC just said we were doing everything we could and not to worry about it. I tried repeatedly all that afternoon to wake her up to feed. Late that night, she was diagnosed with slight jaundice. I would get her to latch on, then she would fall asleep. I quickly learned plenty of tricks to wake her up, but we still had trouble. By the time we were set to leave the hospital, her pedi, whom I had researched plenty to know to trust her, recommended supplementing with formula. I resisted but she convinced me it was best for her at the time. Because I was so determined that would be short-term, we cup fed her so she would have to "lap up" the milk with the same tongue motion it takes to BF. The next day my milk came in, I bought a PISA, and I have been pumping ever since. Of course I really wish we hadn't "had" to try formula (or that I had begun pumping before the problem arose), but she hasn't touched the stuff since she was 7 days old so at least I know she has all the benefits of BM. My supply is fine.

At that point, we were able to get just one good BF session a day, though I continued to try constantly. At 5 days old, we went back to the hospital and learned that even when we were able to get her to latch on and stay awake (or, more accurately, when she would enable us to wake her up), she was taking in very little milk. The LCs weren't and still aren't sure why that was a problem for her; even though she was small at birth, she was full-term. (She was two days late, apparently wanted to wait for Thanksgiving!) I went back the next day to ask about trying a supplemental tube to my breast, but that day she wouldn't latch on at all, so we began finger feeding (supplemental tube attached to our finger). She seemed and seems to have great form when sucking on a finger, which she loves doing. We continued that way for almost two weeks, during which time she was now *refusing* to go anywhere near my breast, even with the tube attached and rewarding her. Even though I was convinced she was now strong enough to take in more milk from me, she would push away. She continued to like to be close to my bare skin, and I held her there often, but she refused my breasts. I attended another LLL meeting and asked about her refusal to latch on, and upon recommendation of a LLL member, last Monday we switched to the Haberman bottle. So we're now on our fourth feeding method. Meanwhile I've had mechanical pump problems from day 1 (especially regarding moisture in the tubes) in addition to the total inconvenience and mess of pumping, which just makes the whole process take even longer. I am willing to do this for as long as it takes to get her to latch on consistently, but admittedly only short-term since it's so hard to do when I'm home alone.

I went back to the LCs last Monday and they were still throwing their hands up in the air; at this point I'd prefer never to go back there since they have never given me a suggestion. I wanted her to look at my yellow and cracked scaly nipples and to make sure the flanges were the right size, and she just said I'm pressing the flanges too hard against me, causing pain. (I can't do it any lighter or there's no suction! She agreed that I don't need bigger flanges than I was using, but I had gone up to the 27mm on my own the week prior.) But good news...on Tuesday DD stopped refusing my breast! She still wouldn't latch on, but at least she didn't seem to hate being in the vicinity! I was so optimistic that maybe this was finally the beginning of our transition back to nursing. It hurt horribly as I had (and continuing to worsen) yellow cracked and scaly skin covering both of my nipples, and she wasn't latching on properly those couple of times either, but it was worth it to me just to get her there.

Then Wednesday I woke up in agony. I was quite sure I had thrush due to the condition of my nipples and the fact that I had had antibiotics during labor, and b/c I had a pedi appt the next day I did not call my OB but instead walked around topless. I decided not to try nursing DD that day; I was willing to deal with agony, but at this point it seemed like it might do more harm than good, especially if it was indeed thrush since she wasn't showing signs of it yet herself. I didn't think it was mastitis b/c I didn't seem to have any of the symptoms (I feel fine other than the pain) or risk factors (no plugged ducts at that point). Surprisingly, the next day the pedi said she thought it was bacteria and to go to my OB. I called the OB nurse who thought it was thrush, and a friend of mine who's an OB thought it was thrush, but those were both phone conversations only. They both said to begin Lotrimin, that it wouldn't hurt regardless.

I scheduled an OB appt for the next day, Friday, but Thursday night I was in the most horrible pain of my life, and that was coming from someone who had labored for 34 hours just 3 weeks earlier. I bawled all night long due to the stabbing pains, not sure (and still not sure) why this was happening. DH stayed up with me and took over care of DD. I called the on-call nurse at 3:00am and through my sobs she said I was doing the right thing -- ice, heat, massage/pressure, pump, over and over. We discussed it being a plugged duct, and whether or not that was the right term I followed that treatment. I didn't have a milk blister that I could pop, and this was the first time I had such a lump in my breast, so how could possible mastitis have preceded a plugged duct? Finally I was able to pump one of the two lumps out, which calmed the pain enough for me to get an hour of sleep. I got out about half of the other knot immediately before my OB appt. Sure enough, my OB said it was mastitis. Although I don't feel at all sick or have any of the other common symptoms, he prescribed 7 days of antibiotics. I questioned a) taking antibiotics, and b) whether 7 days would be enough to cure it if in fact that's what it was, and he said 7 days would be fine. Fortunately the weekend was better pain-wise, though early this morning I experienced stabbing pains again. They weren't the insane pain of three days prior, but they were miserable and kept me up all night and morning again. I still have the second half of one of last week's lumps, and another one as well on the left side...and both are still there nearly 24 hours later. Thankfully again DH stepped in to care for DD.

The good news is that between Wednesday and Sunday I couldn't hold DD anywhere near my chest. As of this afternoon, that's getting a bit better, though I'm still really sensitive as I still have two rock-hard, non-budging knots on my left side, plus both painful nipples. I even tried nursing DD for a grand total of 1 minute on each side today to try to get her to help suck them out, but alas, we were just to the point that she may have been able to when I stopped last week. (At least she seemed to latch on perfectly this time! Her interest only lasted the one minute, but I was happy she tried.) Of course, I'll keep trying with DD and with the pump. The bad news is that otherwise I don't feel any better since I began Lotrimin and antibiotics, my nipples are still white and sticky when wet and yellow and crusty when dry (visualize a parched desert), and I don't really know what's going on. I feel like I have all of the symptoms of thrush but the pedi and OB don't think so (and the Lotrimin isn't helping which it should if it's yeast, though honestly I haven't been consistent about applying it), and I don't think I have any of the symptoms of mastitis other than pain (and the antibiotics aren't helping as far as I know, unless they've prevented it from worsening). I'm still worried that 7 days won't be enough, especially as I've already used 3 and I really don't want to have to take another round, but my OB repeated today that 7 days is enough. Plus, I do have these two presumably-plugged ducts on my left side but they are a newer thing, coming last week after the beginning of my shirtless week (today was topless day 6), and I'm not even sure that's what they are either! And no one seems to have any idea what's causing these insane stabbing, shooting pains. (Thus far they only happen at night; I don't have the pains now and the knots are still there.) Is that mastitis?

If you have any ideas about these varying diagnoses, please let me know. Why would my nipples be worsening with their yellow scabs, entirely covering both of my nipples, especially given that DD isn't nursing? Thankfully DD is still showing no signs of thrush. Does that mean that's probably not what it is, even though she had refused to nurse for so long? I'm also curious about treatment given my other complicating factors; e.g. I'd love to take a shower to help my ducts but water kills my nipples. The duct issues are only on my left side, though I've always gotten a lot more milk from my right, and the nipple issues are on both sides. Will Lotrimin help if I use it more, or should I go back to lanolin, or something else? Will cabbage leaves help? I have been heating and massaging/pressing a lot, but it tends to hurt more after I've massaged, even gently. I've read garlic too? What about pump (flange) positioning? (As I said, it's wide enough.) It's so hard for me to tell whether I'm getting milk at any moment since the flanges fill up quickly with condensation. I just don't know what else to try, so I'm just persevering, thinking the knots will eventually budge...hopefully before the incredible pain comes back. Does this sound like mastitis to you? Thrush? Thankfully I don't feel at all sick, just exhausted, in pain, and confused!

And if you have success stories about a DC who wouldn't latch on for their early weeks and suddenly learned to, I'd love to hear! Did you do anything to help them learn, or was it just a matter of giving them plenty of opportunities to practice?

THANK YOU so much for listening to my rambles. I didn't know where to begin, so I just dumped it all on out there -- so sorry! I'm still determined to help DD learn to latch on and to *productively* nurse for the first time, and then to BF for as long as possible, but I am not willing to continue in this pain with so few answers. If DD were causing the pain, it would be worth it as a step in the right direction, but she's not causing what I'm feeling now. I've performed many searches here and on other websites and am just coming up empty. I am very disenchanted with the LCs around here now and would rather not go back, and the LLL leader has never offered to accept phone calls so I'm hesitant to call her. Plus, the medical side of this makes me want to listen to the doctor who can diagnose; I've heard enough sight-unseen hypotheses! I know it will get better, but I want to start enjoying BF as soon as possible, and thus far it's been one issue after another, first with her, now with me.

Your experience is inspirational. Thank you!!!

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Old 12-17-2007, 08:41 PM   #2
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Re: need advice and encouragement - very long



Poor mama! I don't really have any advice, but bravo to you for continuing to try. I think I may have given up if I were you. Have you been able to actually get anyone to physically LOOK at you?? I mean, have any docs been willing to take a look at your breasts to try to really figure out what's going on??? I would be demanding an appointment if I were you....they yellow and cracked nips sounds alarming, not normal, and like you really need to be treated for something. I'm not sure what severe thrush looks like, but if it were bad enough, I don't know if the OTC stuff would be making any difference....

I hope you manage to get some help, both for you and your dd. Good luck, mama. Even if it doesn't work out that your able to get her to successfully bf, you have gone above and beyond in your effort. GL and more .
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Old 12-17-2007, 08:59 PM   #3
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Re: need advice and encouragement - very long

So it sounds like you are really suffering. Do you still have lumps in your breasts? A hot shower with massage may help, and I recommend putting rice into a sock and microwaving it for a minute, then shake it, then one more minute in the microwave. Heat may alleviate some of the discomfort of Mastitus. Think you have thrush? Check out this list: http://www.kellymom.com/bf/concerns/...resources.html
If you do have thrush keep in mind that anything that touches your nipples needs to be boiled for twenty minutes or washed hot with vinegar in the laundry machine. Any nipples on bottles your baby uses or passi need to be boiled too. You can keep passing it between the two of you.
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Old 12-17-2007, 09:14 PM   #4
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Re: need advice and encouragement - very long

Thanks, mamas! Yes, both the pedi (Thursday) and the OB (Friday) looked at me and thought it was bacterial, not thrush. But the descriptions I've read have indicated thrush, and everyone who hasn't looked at me has said thrush. My OB said it was OK to continue Lotrimin, but I haven't seen any improvement with it, so I'm now not sure that it's thrush either. Granted, I haven't been applying it very faithfully with everything else going on!

I've tried showers before pumping, but it's hard since my nipples get so wet and uncomfortable, and now that it's cold outside I'm usually cold again by the time I'm at the pump again. The rice in a sock idea is great as an alternative to the heating pads I've been using. I've actually read that kellymom page and then some...I'm starting to think I've read too much, hence so much confusion since I don't seem to fall in any category! I waited until this afternoon to try nursing again so as not to spead anything to DD, but finally the nurse talked to the OB and he said he really didn't think it was thrush and to go ahead and try nursing so I did. DD never showed any signs of thrush, so either that's because indeed I don't have it, or because due to our limited nursing she never got it from me. I had been thinking the latter, but now I'm leaning toward the former. Still, I'm trying to apply Lotrimin, though it's hard to get it on in time for it to have time to soak in at all before I have to pump again.

Does anyone know what's causing the shooting pains? They're insanely painful!!! Is that common with mastitis?

Again, THANK YOU! And I'd still love additional feedback....
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Old 12-17-2007, 09:24 PM   #5
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Re: need advice and encouragement - very long

There are many causes for shooting pains. One of them is called a vaso spasm, basically a constriction in the breast. Does the pain originate from anywhere in particular?
The clogged duct you are talking about- the lump, can be quite painful and cause shooting sensations. When you do massage don't be too rough, don't want to bruise anything.

I have heard anecdotal reviews of Lethicin supplements helping with mastitus and clogged ducts. Essentially it is supposed to break the fat into smaller molecules and allow it easier passage through the duct.

Nursing is going to resolve all of the Mastitus related symptoms faster than pumping. Much, much faster than pumping actually. B****** uses suction and compression.

Change the position you are nursing in. You may feel silly, but orient yourself over your baby so that gravity is helping to drain the breast. Yes, I really mean all the way over baby. Also good to note that baby's chin does all the work massaging the milk out of the breast so point baby's chin at the lumps.

what else have you tried so far!?
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Old 12-17-2007, 09:31 PM   #6
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Re: need advice and encouragement - very long

Mama you are an inspiration to us all. I wish more moms cared so much about bf and not giving up.

I'm so sorry the LC haven't been any help. Is there someone else you can call? Maybe a midwife or doula that has had some bf training? I se that you are in Northern CA I'm sure there are lots and lots of other people who could help you out.

Mastitis and thrush (which is yeast) can cause pain. If you say that DD isn't showing signs of it I'm hesitant to say it is thrush because usually it is highly spreadable; even if you only get DD on the brest a few moments. But I wouldn't rule it out as I've seen mamas get it without baby showing signs. Have you tried gental violet and lots and lots of yoguart. Both of which are awesome for thrush. GV can be bought at a health food store and but on the nipples here's a link for on info for it:
http://www.kellymom.com/newman/06gentian_violet.html


This link also has some awesome info on pain from thrush.
I will be back to add more. DS is crying and needing me. But before I go I just want to give you another
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Old 12-17-2007, 09:34 PM   #7
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Re: need advice and encouragement - very long

I don't have much experience with this except the pumping issue, and I know that I suffered from alot of the same problems as you just as a result of solely pumping and not nursing via baby at the breast as it should be. I had plugged ducts very often since pumps don't empty the breast in the same way a baby does, and it can also cause sore/dry/cracked nipples and mastitis.

I mostly wanted to say GOOD FOR YOU for not giving up. So many people throw in the towel before they even get home from the hospital, and you are definitely getting a run for your money and still doing what's best for your DD. Also, although I couldn't since my son was tongue-tied, I do want you to know that I know many people have gotten their child to latch on later, even after taking bottles and pacifiers and even being formula-fed. It IS possible!

Good luck!
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Old 12-17-2007, 09:35 PM   #8
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Re: need advice and encouragement - very long

wish I could help
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Old 12-17-2007, 09:59 PM   #9
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Re: need advice and encouragement - very long

I admire your effort to try so hard to do the right thing for your child!

My DS and I have had thrush for about 12 weeks now.. I do have shooting pains....not very strong ones....but no nipple discoloration or scales. I am not sure about that one. We tried the Drs. meds and they didn't work for us.The lumps are not thrush though you may have both mast. and thrush! Do you have any temp??? (I also had pains w/ Mast. not really shooting though).

I do know that when baby is nursing the jawl/chin should be pointed toward the blocked duct....something about the pull of milk is strongest from the bottom of the mouth. Nursing while on all 4s(letting breast dangle away from chest to free up ducts) while chin is in right postion helped....but it was quite a chore. If you need more explaining PM me.

This may sound silly but have you tried a nipple shield? My DD had a hard time latching and I used that the 1st 3 weeks.

I think if I were you I would treat myself as if I had thrush (naturally- it can't hurt you) and see if some of these symptoms go away.
Start a yeast-free diet (that includes dairy, some fruits, starches,...) Take acidopholis(lots of the good stuff from vitamin shop-fridge section w/ billion per capsule), clean breasts after every nursing/pump throughout day w/ vinegar/water/teatree oil mixture. Wash all your tops, bras, sheets, towels ans such on hot and add vinegar to extra rinse. There is lots of good stuff online about treating thrush.

Also maybe you can find an osteopath(spelling) Dr O.D. instead of M.D.

I hope things get better for the 2 of you. I will be praying.

Last edited by kalynn; 12-17-2007 at 10:03 PM.
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Old 12-17-2007, 10:00 PM   #10
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Re: need advice and encouragement - very long

You are doing an amazing thing by continuing. Keep it up!
I don't have a lot of experience with your problems, but here a few thoughts. I did have the shooting pain and it seemed to be a clogged duct that cleared up when I was able to nurse a lot on the affected side. If you decide to go back to lanolin at some point, I highly recommend using Earth Mama brand Nipple Butter instead. Lanolin did not help me at all with soreness, but the nipple butter helped immediately. Of course, this is not if you are having thrush or something more serious. Regarding your pump, I have a handheld one from Medela that has worked really well. I only mention it in case you are thinking you'd like to try another one, this would be an option that is not too expensive. My next suggestion might be really off base....would a nipple shield be something to use for a while? I hope others do jump in and correct me if it's a really bad idea. I was just wondering if you used one then maybe you and DC could tolerate nursing and then you could work away from it later.
And finally, there is a group in my area that offers phone support. http://www.nursingmotherscounsel.org/
Maybe you can call them or find a similar such organization closer to you.
I wish you the best of luck. Once this is all straightened out I'm positive you will enjoy the bfing experience.
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