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Grazed nipples - how long to heal?


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#1 Agnodice the Feral

Posted 29 April 2012 - 09:27 AM

Quick question.

Have small grazes on both nipples - yes they are only small but they hurt! Have worked on our latch with an LC, things are getting better - but the grazes won't heal.

Between the LC and my MCHN and the internet, I've been told varying things - express and give EBM for 24-48 hours and they'll heal completely; just keep feeding with a correct latch and they'll heal rapidly; they should be healed already etc.

Well, I've tried all those things. I'm really not enjoying expressing as it takes a while, and poor bub much prefers the boob to any other method of feeding (just use a bottle, don't use a bottle and use a spoon/syringe/etc instead). I've kept feeding him, and though they’re not getting bigger, they're not getting smaller.

ANd yes they're sore, but manageable with some painkillers, so I'm happy to just keep feeding him. I guess though my concern is that I can't spend the next year taking painkillers, and at some point surely they will heal?! But how long will that take?

All my friends have given me answers like - "oh, yeah, I remember that stage... um, no I can't remember how long it took, but one day it just got better" - when is that magical 'one day'?

PS - DS is 2.5 weeks old, so they've been there for about 2 weeks now.

Edited by MsN, 29 April 2012 - 09:28 AM.


#2 Frau Farbissina

Posted 29 April 2012 - 09:35 AM

Oh I remember the pain! I used Lansinoh regularly and from memory it took a couple of days for it to heal up. Also had to just grit my teeth it was soo uncomfortable when baby was feeding. Happened a few times with both of my kids, but it wasn't long term - the Lansinoh really helped to soothe and heal, and it's safe for baby. Good luck!

#3 monnianni

Posted 29 April 2012 - 09:36 AM

My DD3 is 10 weeks now, and I had grazed nipples and a big split in each for the first 3 weeks.  The LC told me to use a thin smear of Lanioh and leave my nipples open to the air as much as possible. I used to  leave the flap open on my nursing bra as much as possible.  Not comfortable, and a bit leaky, but once  did this they graze healed within a couple of days, the split took over a week, but within 10 day they were both healed and I haven't had an issue since.



#4 Libertine

Posted 29 April 2012 - 09:38 AM

Get some nipple shields. They allow you to keep feeding but allow the nipple to heal.

Mine were really bad but once I did this they healed within about 3 days. yours might be quicker as mine were majorly cracked, bleeding etc.

Some people, especially the MCHN's, don't advise using the shields due to nipple confusion but I did not find this a problem. For me nipple shields were a life saver. I would have given up due to such intense pain but they got me through it and I went onto breastfeed for 12 months.

#5 GoodGollyMolly

Posted 29 April 2012 - 09:39 AM

It's excruciating isn't it? I've had a couple of bad patches with DS (now 10 weeks). The first time they healed after about 10 days once DS had his tongue tie corrected. I was using buckets of lanolin cream but I remember the thing that helped most was having a radox bath and soaking them. This is a bit gross, but it let the scabs gently come away and once I got to the pink skin underneath they were much better.
Similarly had another bad patch about a week ago that lasted about 6 days, after a swim in the ocean the scabby bits came off and felt better again.
Well done for persevering, and hope it gets better soon.

#6 Tall Poppy

Posted 29 April 2012 - 09:41 AM

I found it to be a week to ten days, the few times I've had issues. I kept feeding from the breast the whole time though, I think for me this is best. I wasn't willing to compromise our feeding for my discomfort. Disclaimer - this was what was right for me and my child, everyone is different.

Try gently rubbing some breastmilk in, I found this really good better than other methods. Otherwise some purified lanolin may help, if it's purified you don't need to wsh it off before a feed.

Do you think it's infected? If there is an infection it won't heal, however, I'm sure you would most likely realise if it were infected.

I hope it improves for you soon. Just looked at who the OP is as a Dr I'm sure you'd know the signs for infection so I doubt that is it.

#7 SeaPrincess

Posted 29 April 2012 - 09:44 AM

Lansinoh, open air and sunlight will help, then it should take less than 2 weeks.  Nipple shields made mine worse.  I also had laser treatment from the physio, but I only managed 1 treatment, so the sunlight helped more (I lay in a sunny patch by the window).

R

#8 deejie

Posted 29 April 2012 - 09:50 AM

Hi MsN, glad to see you found yourself an LC original.gif

I had nipple grazing in the first two weeks due to some early attachment issues with DS2. After we fixed those problems, the grazes took about another two weeks to heal completely. I remember by the time he was a month old my nipples were in tip top shape wink.gif

I had an independent midwife and what she advised me was buckets of lanolin both before and after feeds and air as much as you can (I kept my shirt off most of the time, but I was lucky because DS2 was a summer baby). The improvement was slow but steady and I was always reattaching DS2 to keep the latch good (he had a tendency to pull back).

Good luck original.gif

#9 Agnodice the Feral

Posted 29 April 2012 - 10:02 AM

Thanks everyone! An up to two week timeframe I can live with  biggrin.gif

Open air feels best and I know they’ve been getting macerated under my bra/hydrogel dressing so they don't stick to my bra - but my dad has been here for two weeks and I couldn't really walk around topless at home! He goes home today, so I'm looking forward to the air time.

QUOTE (BadKitteh @ 29/04/2012, 09:41 AM) <{POST_SNAPBACK}>
I found it to be a week to ten days, the few times I've had issues. I kept feeding from the breast the whole time though, I think for me this is best. I wasn't willing to compromise our feeding for my discomfort. Disclaimer - this was what was right for me and my child, everyone is different.
Just looked at who the OP is as a Dr I'm sure you'd know the signs for infection so I doubt that is it.


I actually would prefer to just keep feeding and i know what you mean about compromising feeding - poor DS was so sad by the end of the da¥ yesterday after expressing for a day he just wouldn't settle without comfort sucking on my finger (which he normally spits out). But people kept scaring me saying things like "open grazes are a source for mastitis and you really SHOULD get them healed as quickly as possible..." which was the only reason I tried to give them a break. So I'm actually quite happy to go back to taking panadol and keep feeding.

And no its not infected, but being a doctor doesn't mean much now, LOL! It's still a learned skill, no matter what theory you know!






#10 lucky 2

Posted 29 April 2012 - 02:26 PM

Theoretically your nipples should heal if they are no longer getting friction or compression when bfing, that would mean that is your nipple ended up deep in your babies mouth then they will be out of mechanical harms way and "should" heal.
Nipple damage and pain continuing and not healing could be one of 5 things, ongoing mechanical compression (ie latch better but not optimal), infection (ie fungal or bacterial), nerve pain, vascular issues (ie vasospasm) and occasionally there are women who have ongoing pain in their nipples despite a good latch, absence of infection or any other known causes and they would be grouped into the "unknown causes" 5th category.
If it is nipple trauma not healing then it is likely from ongoing mechanical compression +/- infection (fungal or bacterial). Now being a Dr yourself I trust you would be alert to the presence of a bacterial infection in the nipple wound (and you don't think there is bacterial infection) and if there are no other signs of nipple thrush (ie burning, stinging, presence of oral thrush in baby, recent antibiotic use) then it is probably not fungal infection.
So that leaves ongoing nipple compression, is your nipple at all misshapen after the feed?
I'd keep working on deep attachment, get back in touch with your LC for guidence, use ebm and some medical grade lanolin, assess for presence of infection (then consider use of fungal gel or cream or even a prescribed cream (antifungal/antibacterial).
It is better usually to keep feeding and try to improve latch and/or treat any infection but sometimes things just get worse and expressing is required for healing.
It is unfortunate but not uncommon for things to not be sorted out at 2.5 weeks but it sounds like you are doing everything to help and are moving well in the right direction.
All the best.

#11 libbylu

Posted 29 April 2012 - 02:41 PM

Depending how serious the damage is.  I had a crack which became a blister which became an open pussy wound on my right as well as several other smaller cracks and blisters on both sides.  It was excrutiating and I don't know if I could go through it again.  But it was all healed up and toughened up by 5 weeks.  No issues beyond then.  I think smaller problems might take a week or two, but maybe do 48 hours feed, 48 hours express, and repeat the pattern, if you can keep it up without getting mastitis, which is what happened to me when I only expressed off the damage nipple.
Most people are over the worst by 2-3 weeks.

#12 Tall Poppy

Posted 01 May 2012 - 09:33 AM

QUOTE (MsN @ 29/04/2012, 10:02 AM) <{POST_SNAPBACK}>
I actually would prefer to just keep feeding and i know what you mean about compromising feeding - poor DS was so sad by the end of the da¥ yesterday after expressing for a day he just wouldn't settle without comfort sucking on my finger (which he normally spits out). But people kept scaring me saying things like "open grazes are a source for mastitis and you really SHOULD get them healed as quickly as possible..." which was the only reason I tried to give them a break. So I'm actually quite happy to go back to taking panadol and keep feeding.

And no its not infected, but being a doctor doesn't mean much now, LOL! It's still a learned skill, no matter what theory you know!


I certainly didn't mean to imply that it would be easier for you as a Doctor, sorry if it came out that way. What I meant was you would be better at spotting symptoms and signs of infection than someone who was not a Doctor. You are a right it is a learned skill for Mum and baby, it takes time and patience.

I hope things are better for you and you're on the mend and baby is doing well.

My understanding of Mastitis is that it is infection within the ducts deep within the tissue of the breast. When a duct becomes blocked with milk if not removed out of the duct it may become infected. Grazing to nipples is different again as it is the areola and nipple that are damaged and these can become infected as well but it is not by definition Mastitis. Both are painful and require care, however, most current advice indicates that continuing to feed is best in the short and long term. (I am a volunteer for the ABA and by no means an expert but do keep up to date with the latest information).

libbylu - I agree about the blister pussy wound, I had that with DS and oh my it was nasty. The sweet relief when it popped and then the pain again until it healed. I think of this when contemplating TTC 3. By the 6 week mark it was all running smoothly with DS.

#13 SeaPrincess

Posted 01 May 2012 - 08:04 PM

QUOTE (MsN @ 29/04/2012, 08:02 AM) <{POST_SNAPBACK}>
Thanks everyone! An up to two week timeframe I can live with  biggrin.gif

I can still remember weeping over DD as I fed her.  When Mum told me 2 weeks, I thought she was insane. But she was right!

#14 bikingbubs

Posted 01 May 2012 - 08:09 PM

Yup about 2 weeks for me too .... And oh boy do I remember the wincing every time he attached.  Never had any problems after they healed original.gif

#15 Etienne

Posted 01 May 2012 - 08:18 PM

I had the same issues early on and reckon it healed by the time bubs was 4 weeks.

My mum went to the chemist and bought me Lansinoh, Multi-Mum Compress and Hydrogel Breast Discs.  All of these helped in some way and aided the healing process for me.

I still use Lansinoh when they get dry or DD has a particularly long feed.. it's kept in the nappy bag!

Good luck and hope you feel better soon.

#16 sigh

Posted 03 May 2012 - 08:26 PM

I think my grazes settled down at about 4 or 5 weeks. I didn't really notice them as I had mastitis repeatedly.

#17 Agnodice the Feral

Posted 04 May 2012 - 01:58 PM

Thanks everyone!

I also ended up getting treated for thrush due to the burning pain after feeds - I'm still not sure if it was really thrush or just nipple pain, but anyway...

And you were all correct - four days on they are about half healed, so two weeks should do it. And they are nice and scabby so they don't hurt as much now.

Entirely incidentally - I'm not sure I believe in moist wound healing.... It's based on a 1962 paper by a zoologist named Winter who did an extremely poorly designed study involving a couple of pigs and some cellophane and found an extremely marginal increase in healing time. But it was just an observational study, it had no statistical power, and really is pretty crap. An yet has driven wound management for 50 years!

I actually found all the hydrogel dressings and Lansinoh made everything a lot more painful and macerated. I git rid of all the dressings/products on Monday and just wore a t shirt for a day, and it was all dry and scabbed over. And I'm rather fond of the scabs... I can now feed without any pain at all because the nerve endings in an open wound are protected by thick scabs. There's something to say for that! Sure it might take a day longer to 'heal' under the scabs... But in the scheme of things, that's not so bad!

#18 zogee

Posted 04 May 2012 - 05:29 PM

oooh ow! you poor thing. I had a really scabby nipple on my right side and completely rested it for 4 days, (pumped exclusively) then saw an LC to check our latch before I put my son back to the breast on that side. The scab dropped off after another week maybe? I used to dry it off with a hairdryer on cool after a shower and used breast pads with lansinoh to stop it sticking to my bra.
In my case I think nipple shields contributed to my problems as my son's mouth would slip off the silicon and then chomp the end of the nipple  ohmy.gif plus the nipple ended up very soggy.
I found also that as my son grew and my nipples were drawn out more by feeding constantly the latch problems we had disappeared. I hope this is the end of your troubles too! original.gif




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