Tuesday, February 11, 2014

Pain During Nursing

Many women do experience pain at some point during their nursing journey. Breastfeeding educators usually tell moms that there shouldn't be pain during nursing if the latch is right, which is generally true. However pain does often crop up. Generally speaking, if there is pain during nursing, it's one of a handfull of things MOST OF THE TIME. But there are always exceptions to the rule. Below is an explanation of common causes of pain and some links to articles I trust:
  1. Poor Latch:
    OFTEN in the early weeks of nursing, getting a good latch can be difficult. I'd say that more often than not, this is the cause of MOST pain during nursing and is MOST OFTEN the cause of nipple damage. Usually the problem is that baby doesn't get enough breast in the mouth, making him pinch the tip of the nipple while he is nursing. This can be the cause of cracked & bleeding nipples.  I tell moms to sandwich the nipple between the thumb and forefinger, tickle baby's nose with the tip of the nipple (he wil naturally open up wide as a response), and SHOVE that sandwich in baby's mouth as far in as it will go, aiming the tip of the nipple to the roof of the mouth. There are other techniques described in the links below. You need a good amount of breast in the mouth to get baby to latch well. Try this. Latch does get better with time. Keep correcting it if there is pain. As baby's mouth grows and baby's muscle control gets better in the first weeks and months, latch becomes less and less of an issue. It's hardest in the begining. Hang in there. Get help from a lactation consultant or lactation educator. Know that this can be solved with help and with time!!

    Here are some articles with pictures showing a good latch:

    Link to PDF on latch from La Leche League:
    http://www.llli.org/docs/75.pdf

    Great article with good illustrations and other links from KellyMom.com
    http://kellymom.com/ages/newborn/bf-basics/latch-resources/
  2. Yeast or Thrush:
    So, if your latch is good, another pesky problem can be yeast. Yeast is a fungus that is found in the birth canal (vagina) and can be transfered to baby during birth. Yeast also lives on surfaces all around our environment and can find its way into baby's mouth or your nipple in many other ways. If you have a yeast infection (also called thrush) in your nipple it can be very painful, often causing a burning sensation that radiates through the breast during nursing. If you are experiencing burning pain in one or both breasts, GO SEE YOUR HEALTH CARE PROVIDER SOONER RATHER THAN LATER. They can perscribe an antifungal treatment (oral or topical) to get rid of the yeast. See a doctor and they can make the proper evaluation.

    Link to article on yeast/thrush from La Leche League:
    https://www.llli.org/llleaderweb/lv/lvoctnov98p91.html

    Link to a compilation of great resources on yeast/thrush from KellyMom.com
    http://kellymom.com/bf/concerns/child/thrush-resources/
  3. Mastitis:
    If latch is good, and it's not yeast, pain during nursing can often be caused by mastitis. Mastitis is a bacterial infection of the breast. Moms who have mastitis can have pain in one or both breasts. They often have symptems of feeling 'run down', which is hard to pinpoint being a new mom. But it's more than just being exhausted from motherhood, it's feeling like you've got a bug of some sort. Moms often will run a fever. If you have general illness sympoms along with breast pain, SEE YOUR HEALTH CARE PROVIDER SOONER RATHER THAN LATER. A doctor or other health practitioner needs to diagnose mastitis and then can perscribe an antibiotic.

    Link to article on mastitis & plugged ducts from La Leche League:
    https://www.llli.org/nb/nbmarapr07p76.html

    Link to artile on mastitis and plugged ducts from KellyMom.com:
    http://kellymom.com/bf/concerns/mother/mastitis/
  4. Plugged Ducts:
    Something that can preceed mastitis or occur independently is a plugged duct. This happens when the tubes that carry your milk out through the nipple get blocked from some dried or thickened milk. This can cause lumps in the breast as well as pain. Sometimes you'll see a white dot on the nipple, called a bleb, that is evidence of a plugged duct right at the tip of the nipple.  The articles under mastitis also deal with plugged ducts. I'll include some articles below that deal specifically with plugged ducts:

    A mom's story about plugged ducts from La Leche League:
    http://www.llli.org/nb/nbmarapr06p68.html

    Solutions to dealing with plugged ducts from La Leche League:
    http://www.llli.org/docs/0000000000000001WAB/WAB_Tear_sheet_Toolkit/17_dealingwithplugsblebs.pdf

    An article about using lecithin (a supplement) that can help with plugged ducts
    from KellyMom.com
    http://kellymom.com/nutrition/vitamins/lecithin/
  5. Vasospasm or Ranaud's Syndrome:
    This is more rare, but I have heard a few moms talk about it. Sometimes there is a spasm of the blood vessles in the breast and nipple that carry blood away from it. It can cause pain during or after nursing. It is often accompanied with blanching of the nipple. Experts say that blanching is USUALLY caused by a poor latch, but that said, it can be this.

    An article about nipple blanching and vasospasm in the nipples from KellyMom.com:
    http://kellymom.com/bf/concerns/mother/nipple-blanching/

    A wiki article on Ranauld's Phenomenon:
    http://en.wikipedia.org/wiki/Raynaud%27s_phenomenon

    La Leche League didn't have a whole article, but this blurb within an article:
    Vasospasm of the nipple (Raynaud’s phenomenon) has been reported. This may manifest as blanching and pain of the nipple, either spontaneously or after nursing. This may or may not be associated with other manifestations of Raynaud’s phenomenon or rheumatologic disease. Avoiding nipple trauma and keeping the nipple warm can prevent some of the occurrences. Calcium channel blockers may be used in severe cases.https://www.llli.org/ba/may01.html
  6. Other causes of nipple pain:
    Above are the biggies--the most common sources of pain while nursing. If it's not any of those, it will take some evaluation from a lactation consultant and/or doctor. Get help from a professional!! I'll include some links to articles about pain while nursing and solutions for soothing irrititated nipples. Hopefully with time and some professional help, you can get things feeling better soon!!

    "Nipple Pain: Causes, Treatments and Remedies" from La Leche League:
    https://www.llli.org/llleaderweb/lv/lvfebmar00p10.html

    "Healing Tips for Nipple Cracks or Abbrasions" from KellyMom.com
    http://kellymom.com/bf/concerns/mother/nipplehealing/

    "Why are my nipples sore after months of pain-free nursing" from KellyMom.com
    http://kellymom.com/bf/concerns/mother/sorenipples-older/

    An Article About Tongue Tie--possible cause that needs to be evaluated by a health care practitioner:
    http://www.breastfeedingbasics.com/articles/tongue-tie

    Where to get help from a professional Lactation Consultant/Educator in and around Door County, WI:
    http://www.doorcountylatch.blogspot.com/p/lactation-support-in-area.html


    I hope this helps!!!!