Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 Namaskar Group, I have a mom in my practice who has a five week old baby. She says her nipples are so sore that she is feeling housebound because she cannot stand to put on a tee shirt or bra. She is rubbing breast milk into her nipples at least five times per day then using lanolin. Because the pain is the first thing she notices upon waking each day and is becoming so much a part of her attention, she is about ready to take a pain reliever like Tylanol. Any suggestions? Thank you. Kim Luchau infant craniosacral therapist Kaua'i, Hawaii phone: 808.822.4644 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 i would: stop the breastmilk into nipples only use coconut or olive oil on nipples for now express milk before having infant latch on cut large nipple holes in bra and let t-shirt rub against nipples can use organic wine or organic beer or valerian, hops, passionflower to help relax frequent nursing so infant does not get too aggressive on nipple several slow deep breaths while expressing milk before latching on this will help, Shawna midwife over 30 years. mother of 4 jivanimark <jivanimark ayurveda Tuesday, June 10, 2008 7:09:19 PM PerinatalAyurveda forum nipple soreness Namaskar Group, I have a mom in my practice who has a five week old baby. She says her nipples are so sore that she is feeling housebound because she cannot stand to put on a tee shirt or bra. She is rubbing breast milk into her nipples at least five times per day then using lanolin. Because the pain is the first thing she notices upon waking each day and is becoming so much a part of her attention, she is about ready to take a pain reliever like Tylanol. Any suggestions? Thank you. Kim Luchau infant craniosacral therapist Kaua'i, Hawaii phone: 808.822.4644 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 Hi Kim, Two things come to my mind. It sounds like her baby might not be latched on deep enough--shallow nursing can definitely cause nipple pain. Here are links to some articles/pictures about correct latch. http://www.kellymom.com/newman/a-when_latching.html http://www.kellymom.com/bf/start/basics/latch-resources.html http://www.llli.org/FAQ/sore.html Another possibility is thrush. Has she checked the baby's mouth for any patches of white? She might see them on the inside of babe's cheeks, inside the lips and possibly on the tongue. Sometimes a baby will have no symptoms in the mouth but will have a diaper rash caused by yeast--usually in the genital area, often resembles a mild burn; it may peel or look like a patch of red dots. How do her nipples look? Thrush on nipples can look shiny, reddened, swollen, tender and sometimes cracked. Occasionally peeling or a red, dotty rash can be seen on the nipples. There can be itching, flaking and a burning sensation. Here's a bunch of info w/treatment plans: http://www.kellymom.com/bf/concerns/thrush/thrush-resources.html Blessings, Kristina --- jivanimark <jivanimark wrote: > Namaskar Group, > > I have a mom in my practice who has a five week old > baby. She says her nipples are so sore > that she is feeling housebound because she cannot > stand to put on a tee shirt or bra. She is > rubbing breast milk into her nipples at least five > times per day then using lanolin. Because > the pain is the first thing she notices upon waking > each day and is becoming so much a part > of her attention, she is about ready to take a pain > reliever like Tylanol. Any suggestions? > > Thank you. > > Kim Luchau > infant craniosacral therapist > Kaua'i, Hawaii > phone: 808.822.4644 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 Kristina's suggestions sound right on. I would think if it was a latch problem she wouldn't have lasted this past 5 months without going to a LC. And if the pain starts first thing in the morning, sounds like yeast. She NEEDS to see a LC at her hospital or somewhere. Probably needs a prescription. Yeast feels like burning, itching and sometimes feels like shards of glass in the breasts between feedings. I would not suggest coconut or olive oil on nipples at this point, nor wine or beer for relaxation. Nothing but Dr. Jack Newman's APNO and an oral prescription for thrush unless she has had a bad latch all this time. Vicky York, IBCLC, CPD Postpartum Care Services Portland, Oregon http://mypeoplepc.com/members/vmyork/ www.ikarma.com/user/vmyork - kristina wingeier ayurveda Tuesday, June 10, 2008 6:11 PM Re: PerinatalAyurveda forum nipple soreness Hi Kim, Two things come to my mind. It sounds like her baby might not be latched on deep enough--shallow nursing can definitely cause nipple pain. Here are links to some articles/pictures about correct latch. http://www.kellymom.com/newman/a-when_latching.html http://www.kellymom.com/bf/start/basics/latch-resources.html http://www.llli.org/FAQ/sore.html Another possibility is thrush. Has she checked the baby's mouth for any patches of white? She might see them on the inside of babe's cheeks, inside the lips and possibly on the tongue. Sometimes a baby will have no symptoms in the mouth but will have a diaper rash caused by yeast--usually in the genital area, often resembles a mild burn; it may peel or look like a patch of red dots. How do her nipples look? Thrush on nipples can look shiny, reddened, swollen, tender and sometimes cracked. Occasionally peeling or a red, dotty rash can be seen on the nipples. There can be itching, flaking and a burning sensation. Here's a bunch of info w/treatment plans: http://www.kellymom.com/bf/concerns/thrush/thrush-resources.html Blessings, Kristina --- jivanimark <jivanimark wrote: > Namaskar Group, > > I have a mom in my practice who has a five week old > baby. She says her nipples are so sore > that she is feeling housebound because she cannot > stand to put on a tee shirt or bra. She is > rubbing breast milk into her nipples at least five > times per day then using lanolin. Because > the pain is the first thing she notices upon waking > each day and is becoming so much a part > of her attention, she is about ready to take a pain > reliever like Tylanol. Any suggestions? > > Thank you. > > Kim Luchau > infant craniosacral therapist > Kaua'i, Hawaii > phone: 808.822.4644 > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 Dear Group, Thank you for the assistance. I look forward to being in contact with this mom. Again, the baby is only five WEEKS old. Vicky said, as I have left in the text below, five months. The baby and mom have had many challenges that I won't go into in details here. Primarily the baby was not gaining weight until this last week. Now he is only 7 ounces over his birth weight. He had a staff and e coli infection and was in the hospital, which traumatized the mom, etc. Any more suggestions or comments are greatly appreciated! Regards, Kim Luchau ps this is her first child. --- VMYORK wrote: > Kristina's suggestions sound right on. I would think > if it was a latch problem she wouldn't have lasted > this past 5 months without going to a LC. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 He was probably given antibiotics for the infections and that may have given him thrush. Poor mom and baby both are traumatized. I hope she goes to an LC. It still sounds like a latch needs to be corrected and check for yeast transferred from babe to mom. Vicky York, IBCLC, CPD Postpartum Care Services Portland, Oregon http://mypeoplepc.com/members/vmyork/ www.ikarma.com/user/vmyork - jivani ayurveda Tuesday, June 10, 2008 8:59 PM Re: PerinatalAyurveda forum nipple soreness Dear Group, Thank you for the assistance. I look forward to being in contact with this mom. Again, the baby is only five WEEKS old. Vicky said, as I have left in the text below, five months. The baby and mom have had many challenges that I won't go into in details here. Primarily the baby was not gaining weight until this last week. Now he is only 7 ounces over his birth weight. He had a staff and e coli infection and was in the hospital, which traumatized the mom, etc. Any more suggestions or comments are greatly appreciated! Regards, Kim Luchau ps this is her first child. --- VMYORK wrote: > Kristina's suggestions sound right on. I would think > if it was a latch problem she wouldn't have lasted > this past 5 months without going to a LC. Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 Dear Vicky, Yes, he was given antibiotics. And, yes, they were both very traumatized. The mother is a Christian Scientist and had never been in the hospital before in her life. To be told her two and a half week old baby has a staff infection that may kill him overnight was huge. Just today the mom called saying she recognized she is stressed and needs help. I am grateful she is seeing it because I saw problems beginning to surface and was concerned in many many ways. I will support her through the thrush situation as I can. I have been craving team support here and fortunately she is finally saying she wants community help. I could see that the mom has been so mentally concerned that her milk production was low, but fortunately that is no longer an issue. She and the baby were not bonding well. Aye, the problems were stacking up. The baby was beginning to spit up a lot, etc. She was working with a LC, but did not feel she was getting anything from her. She has also consulted with a La Leche league leader who I am also speaking with so that I can reiterate what she says. How to settle into being a mom? I keep asking myself how I can support this journey for her. Once again, any words of wisdom are welcome. And, a big thanks for what has already been offered. Warmly, Kim Luchau --- VMYORK wrote: > He was probably given antibiotics for the infections > and that may have given him thrush. Poor mom and > baby both are traumatized. I hope she goes to an LC. > It still sounds like a latch needs to be corrected > and check for yeast transferred from babe to mom. > Vicky York, IBCLC, CPD > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 Hi, For the soreness (which I experiences with my first), I'd recommend applying wash cloths with salt water and alternate that with chamolie tea. I've even just dunked my breasts into a cup full of salt water or chamomile tea. Works like a charm! Breast wishes, Ananga-manjari ayurveda , " jivanimark " <jivanimark wrote: > > Namaskar Group, > > I have a mom in my practice who has a five week old baby. She says her nipples are so sore > that she is feeling housebound because she cannot stand to put on a tee shirt or bra. She is > rubbing breast milk into her nipples at least five times per day then using lanolin. Because > the pain is the first thing she notices upon waking each day and is becoming so much a part > of her attention, she is about ready to take a pain reliever like Tylanol. Any suggestions? > > Thank you. > > Kim Luchau > infant craniosacral therapist > Kaua'i, Hawaii > phone: 808.822.4644 > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 Hi All - All these suggestions sound wise and helpful. Let's add the thought that this Mama-Baby just went through the 5 week growth spurt also, which along with the hospital stressors have encouraged more frequent nursings to build the temporary " low " supply and to sooth the emotions. THis also can be contributing in this case to nipple soreness. Jivani, for Mom of course a gentle ayurvedic hot oil massage will be paramount for helping her reduce the stress levels and return from cortisol dominated to rejuvenation mode. In my opinion it is a top priority, also automatically creating more natural bonding from her naturally caring instincts being supported as she feels her own psychophysiology being supported. Is she open to some of the dietary supports for herself, including oleation, and some extra efa 3s? Is she sunning her nipples for 10 minutes twice a day? It still is the best thing I've experienced/seen for activating the body's abilty to heal from this soreness, not counting issues around thrush which of course also benefits with the immune boost from the sunshine. We have in the archives ie files section online a long discussion about yeast management options, side effects, results and failures BTW. I'm curious what is being used now, Vicki? Would you help me update with what you are seeing works best and describe the product being used for the oral support? If possible I'd be sharing a few essential oils for their quick prana, hormonal, antiyeast and bonding supports in this mother's situation. Young Living has a wonderful blend specifically for bonding called Gentle Baby, which I've seen even help with animals being brought together in common household, and has many of the sattvic skin healing oils in it. Blessings, Ysha Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 11, 2008 Report Share Posted June 11, 2008 Kim thank heavens you are there for her. She sounds like a set up for postpartum depression. When the " authorities " tell a woman her baby has a problem, any little thing, right in the beginning, she often has a little trouble bonding because subconsciously she withdraws somewhat in case doesn't make it. Her baby has been deemed " not quite ok " and she no feels like she is all he needs and everyone but her knows better than she what is good for her baby. One thing leads to another, now her confidence needs to be boosted and she needs to be assured that he is robust and she is wonderful for him. Work on her latch. The baby must open wide before allowed to start sucking, and make sure the lower lip is out. If it hurts the whole time she is nursing and her nipples are cracked and bleeding, scabbed, sore, she needs help with the latch. If it is just yeast, that can take a long long time to resolve. Find Dr. Jack Newman on the internet and follow his advice to a " T " about latch and also about latch. I never remember how to send attachments to this group but I can send you privately information about yeast. Or Ysha can direct you to some good info that we have downloaded. Mother and baby have to be treated at the same time. The salt water suggestion is good. Also keep nipples clean and dry before closing them up with the bra, change pads frequently, expose breasts to sunlight in addition to the yeast treatment. They both need a few minutes of sunlight each day. I'm putting some info in the body of this e-mail. Vicky Fluconazole (DiflucanT) is a synthetic antifungal agent that can be used for the treatment of a variety of Candida albicans and other fungal infections. For the breastfeeding mother in particular, it can be used to treat recurrent Candida infections of the nipples, and, if such a thing exists, as I believe it does, Candida infections of the milk ducts. Candida (yeast) infections of the nipple and ducts Candida infections of the nipples may occur any time while the mother is breastfeeding. Candida albicans likes warm, moist, dark areas. It normally lives on our skin and other areas, and 90% of babies are colonized by it within a few hours of birth. It, like many other germs that live on us normally, only becomes a problem under certain circumstances. Candida infections of the skin or mucous membranes are more likely to occur when there is a breakdown in the integrity of the skin or mucous membrane-another reason why a good latch is very important from the very first day. Many Candida infections would, perhaps, not have occurred if the mother had not had sore nipples and a breakdown of the skin of the nipples and areola. The oozing of liquid that occurs often in cracked nipples encourages Candida albicans to change from its harmless form to a disease causing form. The widespread use of antibiotics also encourages the overgrowth of Candida albicans. Many pregnant women, women in labour, and new mothers, as well as their babies receive antibiotics, sometimes with very little justification. Diagnosis of Candida infections of the nipples and/or ducts There is no good test which helps makes the diagnosis. A positive culture from the nipple(s) does not prove your pain is due to Candida. Neither does a negative culture mean your pain is not due to Candida. The best way to make a diagnosis is by history. The presence or absence of a Candida infection in the baby is not helpful. A baby may have thrush all over his mouth, but the mother may have no pain. A mother may have the classic symptoms of a Candida infection of the nipples, and the baby may have no thrush or diaper rash. The typical symptoms of a Candida infection of the nipples are: a.. Nipple pain that begins after a period of pain free nursing. Though there are a few other causes of nipple pain that begin later, Candida infection is definitely the most common. The nipple pain of Candida may begin without an interval of pain free nursing, however. b.. Burning nipple pain that continues throughout the feeding, sometimes continuing after the feeding is over. c.. Pain in the breast that is " shooting " or " burning " in nature and which goes through to the mother's back and shoulder. This pain is usually worse toward the end of the feeding, and worsens still more after the feeding is over. It also tends to be much worse at night. This pain may occur without any nipple pain. d.. Pain, as above, which is made much better with the use of gentian violet, though unfortunately, gentian violet does not seem to work as well as it used to. Treating Candida Infections Our first approach to treating these infections is gentian violet (handout #6 Using Gentian Violet) plus all purpose nipple ointment and sometimes grapefruit seed extract (see handout #3b Treatments for Sore Nipples and Sore Breasts and Handout C: Candida Protocol). This approach is safe, works rapidly, and almost always, though there seems to have been a decrease in the effectiveness of gentian violet over the past few years. For this reason, I now use the combination of the ointment and the gentian violet as well as the grapefruit seed extract. A good response to gentian violet confirms that the mother's nipple pain is caused by Candida since little else will respond to gentian violet. It thus also justifies the use of fluconazole, if needed. Even if the above treatment does not help, fluconazole should not be used alone to treat sore nipples and should be added to treatment on the nipples, not used instead. I have not found nystatin to be particularly useful either in treatment of the baby's mouth or in the treatment of the mother's nipples. Clotrimazole cream alone is also not particularly effective in my opinion, but others obviously feel differently. Fluconazole Fluconazole is an antifungal agent that is taken systemically (by mouth or intravenously). It stops fungi (such as Candida albicans) from multiplying, but does not actually kill them. This accounts for the fact that sometimes it takes several days to have an effect. Fluconazole powder is also available and can be mixed with the all purpose nipple ointment instead of miconazole powder. Side Effects Fluconazole is generally well tolerated, but there is no such thing as a drug that never has side effects. Concern about liver injury is exaggerated, since this complication seems quite rare, and usually occurs in people who are taking other medications as well, and who have taken fluconazole for months or longer, and who have immune deficiencies. But it is a possibility that needs to be kept in mind and if it does occur, it can be very serious. Vomiting, diarrhea, abdominal pain and skin rashes are the most common side effects. These are not usually severe, and only occasionally is it necessary to stop the medication because of these side effects. Allergic reactions are possible but uncommon. Call or email immediately if you have any concerns. Fluconazole in the milk Fluconazole does appear in the milk, and this is as it should be, since the idea is to treat infection in the ducts and nipples. It is thus superior to ketoconazole, which gets into the milk in only tiny amounts. The baby will obviously get some, but this drug is now being promoted for use in babies for the treatment of simple thrush. There have been no complications in the baby reported from exposure to fluconazole in the breastmilk. Continue breastfeeding while taking fluconazole, even if you are told that you should stop. Dose of fluconazole Candida albicans is learning to become resistant to fluconazole, and the dose we use has increased over the past few years. Only a few years ago, 100 mg daily for 10 days cured 90% of women of their symptoms. We have now found this to be inadequate. For resistant cases, a newer antifungal agent, itraconazole, can be used, though it may not be the answer either as it does not have a very powerful effect against Candida. Your prescription will be for fluconazole 400 mg as a first dose, followed by 100 mg twice daily until you are pain free for a full week, which usually means at least two weeks. This seems, on the basis of our experience, a fairly good guarantee against relapse. If you have nipple pain continue with the " all purpose nipple ointment " (± gentian violet and grapefruit seed extract) while you are taking fluconazole. However, this means that although most mothers require only the usual two weeks, some need longer treatment. Occasionally it may take up to seven to ten days for the pain to even start going away. Call if there is no relief in seven days. If there is no relief in 10 days, none at all, it is very unlikely fluconazole is going to be of any help. It is sometimes useful to treat the baby as well. The dose for the baby would be 6 mg/kg as a first dose, followed by 3 mg/kg/day as one dose for the same period of time as the mother. Note: The mother's two week prescription is likely to cost between $300 and $350, though there is now a generic fluconazole available which is less expensive. Questions? (416) 813-5757 (option 3) or drjacknewman or my book Dr. Jack Newman's Guide to Breastfeeding (called The Ultimate Breastfeeding Book of Answers in the USA Written by Jack Newman, MD, FRCPC. © 2005 Ayurvedic ideas: Gentian Violet . It works for some and not others and it is messy and will stain so have the mom be careful. Mom and baby should take probiotics. Mom should also avoid sweets so she doesn't get it too and make it worse for baby. Start using more coconut oil and olive oil for mom instead of ghee (I don't cook with the olive oil). I have read that cold pressed olive oil not cooked inhibits the growth of yeast. I also cook with more garlic, ginger, oregano, basil and turmeric. I make stewed apples with clove and anything that gets things moving in the intestinal tract since that is where it all thrives and grows. When a baby or mom has thrush usually the immune system is compromised so building up the immune system is important and I feel getting adequate rest is very beneficial. I t is easily passed back and forth from mom to baby. If mom has it too it her nipples will be very tender and it will hurt when baby latches and it will hurt throughout the feeding. It is a lot easier to clear up in the baby than the mom. Nipples should be kept clean and dry and given air time. Nursing pads, bras, pacifiers, pump parts etc. should be sterilized regularly to avoid becoming re- infected. The mom could also do vinegar wash, I have also seen baking soda paste from one source and I haven't had a client who has tried it but I remember that turmeric on the nipples may be helpful. I have also read that doing a mouthwash of 1/8 tsp. lactobacillus with 1/2c. water is helpful for the baby. Use an eye dropper and squirt the solution on the gums, cheeks and tongue. Vicky York, IBCLC, CPD Postpartum Care Services Portland, Oregon http://mypeoplepc.com/members/vmyork/ www.ikarma.com/user/vmyork Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 12, 2008 Report Share Posted June 12, 2008 i would also recommend lots of skin to skin contact. placing the baby on mom's chest, it would be good to follow the babies lead to try to get the baby to self latch. was the baby checked for tongue tie? mavis Mavis Gewant Sacred Artist & Doula www.sacredmotherarts.com www.gentlecaredoulaservice.com Quote Link to comment Share on other sites More sharing options...
Recommended Posts
Join the conversation
You are posting as a guest. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.