[AvadaKedavra]

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.

This post has been edited by MsN: 29/04/2012, 09:28 AM

[Frau Farbissina]

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!

[monnianni]

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.

[Libertine]

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.

[GoodGollyMolly]

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.

[BadKitteh]

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.

[SeaPrincess]

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

[deejie]

Hi MsN, glad to see you found yourself an LC

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

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

[AvadaKedavra]

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

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.

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!

[lucky 2]

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.