# HELP! Ongoing nipple trauma



## C99 (Apr 7, 2003)

This is going to be one of those "it hurts just to read it" posts.

I have had problems with my right boob/nipple pretty much from the get go. It was the side that was cracked and bleeding when my milk came in. It's the side that got thrush. Somehow it became the "producer" side and the side my 6.5-m/o prefers. And now it's injured and bleeding again. I have 2 small scabs on the right nipple. The do not hurt until she latches and sucks them open again. I am nursing on the left as much as possible and have been applying lanolin on the right, but as the injuries are scabbed over and do not hurt, I am not sure what else I can do to hasten the healing process. I suppose I could nurse exclusively on the left and pump on the right, but I am afraid the pump may pull the scabs out as well. I am not so much worried about myself, but I know that she is swallowing my blood w/ the milk and that worries me. Her stools are black/very dark green, and I can see blood on her cheek when she pulls away. But, she is acting normally.

The books I have only talk about bleeding nipples during the establishment of BFing -- not 6 months down the road! Help! How can I speed up the healing process on my nipple? I have lanolin and breast shells, and I washed the nipple w/ antibacterial soap last night in the bath. Will swallowing so much blood hurt the baby? (I have a call into her ped.) And perhaps most importantly, what can I do to prevent this from happening again? Any advice/suggestions? I have a call into my LC, but home visits are close to $200 and I just cannot afford that right now.

TIA!


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## CinnamonDeMarco (Nov 4, 2005)

You can talk to a LaLeche League leader for free. My LLL leader knows more about BF than my babies' doctor.

You can find a LLL group near you by going to their website. If there isn't a group in your town, find one close to your town. Call the leader and ask for her to listen to your problem and make suggestions.

I'm not a LLL leader but I'll tell what I think:

Try to pump on the sore breast. If you don't get some milk out, you could get clogged ducts.

Get baby on the sore breast as soon as you can stand it.

I have heard of putting strong tea or vitamin E on sore nipples. I tried tea and I guess it felt good.
A little expressed breastmilk applied to your nipples may help.

Avoid washing nipples with soap, soap is unnecessary and it dries the skin on the nipple.

Once baby starts to nurse on the sore breast, use different nursing positions throughout the day so that the same old sore parts are given a break. I got a cut on my nipple when my baby used his bottom teeth to bite me. I could not stand for is teeth to bite me in that spot again. It was so bad I was tempted







to wean. When I nursed him to sleep during the day, I layed him upside down on the bed. I also nursed him while I was sitting on the couch with his body laying next to my lap on pillows. It looked pretty weird but it helped my cut heal.

Let nipples air dry after feedings. You can do this by opening the flaps of your nursing bra or going bra-less. I sleep with the breasts out and free. When you have to be in public, change breast pads often.

What are those nipple shells for? I wonder if they are causing you problems because your nipples need more air.

Stick your finger in baby's mouth to break the latch if your baby bites you or is latched on improperly.

Make sure you let the baby get it's mouth on the nipple. During my son's terrible biting stage I would cringe away from him right as he was trying to latch on. He would suck extra, extra hard to get the nipple. It made my nipples even more sore. It took me many days to figure out my mistake.







I have heard another women at a LLL meeting say she did the same thing. One women said she had sore nipples because she was trying so hard to nurse discreetly in public, that the baby kept latching on incorrectly. She sucessfully nursed all 5 of her children, so things like that can happen to experienced BF moms.

I hope at least one of these things help.


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## C99 (Apr 7, 2003)

Thanks for the suggestions. The breast shells are to keep the nipple wet and to give it air so that your nipple can heal. My LC recommended that I use them (I had a pair left over from the birth of my son) when I had nipple trauma within the first week of birth.

Unfortunately, the next LLL meeting in my city won't happen for another 3 weeks, although I can probably go one at LLLI HQ at the end of next week. I just hope I am not still bleeding by then.


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## timneh_mom (Jun 13, 2005)

Could you hand express for a day on the sore side, and nurse on the other? That would give your nipple a good chance to heal.. and they do heal pretty fast if wounds are not constantly being reopened.


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## CinnamonDeMarco (Nov 4, 2005)

You don't have to wait for the next meeting to call the LLL leader and ask for some suggestions over the phone.


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## Best Feeling (May 11, 2005)

I've had a similar ongoing problem, just not to the same degree as you. Ouch







:

You've already gotten some good advice but I did want to add one thing that helped me. I found that Lanolin either did nothing or helped to trap bacteria (or whatever it is) that caused thrush.

Now whenever I get a cut or a scrape or whatever







I use a combination of triple antibiotic ointment, 1% hydrocortisone, and miconazole (meant for vaginal yeast infection). All of these can be bought over the counter and after a couple of days I always feel better.


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## wombat (Nov 3, 2002)

Stop using that anti-bacterial soap. It'll make it worse. It's too harsh. the saline rinse recommended in the first link would be better.

I'd also recommend stopping the Lansinoh. You've had problems on that side for too long. There's probably bacteria or thrush there that need treating. Open cracks invite bacteria and yeasts to grow. Infection will also prevent healing. Go for APNO if you can get it or make up your own from OTC stuff as previous poster suggested. You use it sparingly after nursing and by the time you have to nurse again, it's mostly absorbed. Won't hurt baby. Take Vit C for healing too.

Info about treating cracked skin here:

http://www.kellymom.com/bf/concerns/...lehealing.html

Info about APNO here:

http://www.kellymom.com/newman/03b-t...s_breasts.html


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## ima062002 (Mar 23, 2004)

Until you are healed always start your baby on your "good" breast and after letdown switch to the injured one if that is the one you are supposed to start off from. Babies suck more vigorously until you let down, so that should take some of the reinjuring away.

Your blood is absolutely no problem in your daughters system.

Since they are cracked you should consult with your doctor about using an antibacterial ointment. Neosporin, Triple Antibacterial Ointment, or Bacitracin are all compatible with nursing. Apply the ointment after feedings once you have rinsed the area with clear water and patted it dry. You do not have to wash it off before nursing again. Simply wipe away any excess that might still be on the surface of the skin with a dry cloth.

Dr. Jack Newman actually suggests an "All Purpose Nipple Ointment " (APNO) for treating any type of nipple trauma that is slow to heal. It's a combination of two antifungal ingredients, one antibacterial ointment, and one steroid to address almost any cause of nipple pain and trauma. The steroid is added for relief of inflammation and pain.

This ointment must be called in by a doctor and is compounded by a pharmacist. It is applied after feedings and can be used as long as needed. It does not need to be washed away prior to feeding.
For an overview on how to make APNO you can go to:
http://www.breastfeed-essentials.com/thrush.html#APNO

I wish you a speedy recovery-
Patricia


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## dlm194 (Mar 23, 2005)

I had a huge crack in my right nipple. I would cry every time my dd latched on and it took 6 weeks to heal! I worked with both a midwife and a LC to heal it. Here are the suggestions I got (some are repeated from previous posts here):

Apply ½ pea-sized amount of cortisone cream + ½ pea sized amount of Neosporin and rub in well.

Rub milk onto nipples after feeding.

Stick nipples in salt water after feeding for about 2-3 minutes each

Apply black tea bags to each nipple after feeding.

All those suggestions (plus lanolin of course) helped, but nothing would heal the crack. I used to walk around with Medela breast shells in my bra b/c it hurt to have anything rub against my nipples.

Finally, I talked to my LC one day and mentioned that my dd had a yeast rash on her bum. The LC figured I had breast infection. I went back to the midwife who didn't really think that was it and reluctantly gave me a prescription for diflucan. I waited a couple days before filling it b/c I REALLY didn't want to take any antibiotics. Out of desperation (and on the verge of quitting), I finally took it and I swear, the next day my nipple began to heal. I wish I didn't need the antiobiotic but I figured that continuing our bfing relationship was worth the 1 shot of antiobiotic.

good luck!


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## indeospero (May 23, 2005)

Yikes! Sorry you're having this problem. I had severe nipple damage, too, and it took forever to start healing. What finally worked for me was, as others have suggested, a combination on Neosporin and hydrocortisone after each feeding (APNO did not work for me), as well as religiously wearing wool breast pads (www.danishwool.com). Lansinoh didn't work at all (maybe made it worse?) but the natural lanolin in the pads did help -- and they prevent rubbing better than breast shells, in my opinion, and keep the area scrupulously dry (in a good way). I really can't say enough about how these pads saved my life! Or at least my nipples. Good luck!


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