Breastfeeding Round Two, (spoiler alert, it didn’t get easier.)
Hello, long time no posting. I thought I’d come back on the day my son turns 18 months old with a specific post about our breastfeeding journey. A mini celebration for making it this far, because I’ll be honest, it was a massive struggle at so many points. Not just in those early days but 9 months in, 11 months, 13 months, I’ve lost count of the amount of cracked nipples, milk blebs and vasospasm issues I’ve had. at points it was driving me to despair.
-”Why didn’t you give up and save your sanity?”- I hear you ask, the simple answer being I’m too stubborn. I breastfed by daughter for 15 months and really hit my stride just past the 5 month mark. So I kept hanging on in there for that eureka moment for a reeeeeally long time. And I don’t think it’s ever happened. I had a cracked nipple about three weeks ago where B bit me, the vasospasm is on and off, yes even when it’s warm. But I love feeding B, it’s something I always wanted to do for as long as I could. So this is our story. With a heavy emphasis on “our story,’ everybody and every baby is different. Doing what your heart and head is telling you is important. How you choose to feed your baby is up to you and nobody else. Fed is ALWAYS best.
Let’s get in to it… So just after B was born he latched pretty well but there was pain and again with this being my second baby you’d think I’d know what I was doing but apparently not. I hear from so many people breastfeeding is painful right at the start, but how painful are we talking?! Well it was 95% tongue tie painful. bleeding an cracked nipple painful. It was the right side again, just the same as with my daughter, the side they prefer but the side that gets shredded. So we had B’s tongue tie cut at 3 days. This throws up all sorts of emotions. I once had someone say to me “I’ve got no idea how you can do that to your poor baby.” I replied that, with there being an incredibly high likelihood my son’s speech would be affected and obviously he was struggling to feed it fell into the no-brainer category… and so did they.
Nipple Vasospasm
After his tongue tie was snipped which took seconds and seemed totally painless he fed straight away and things felt much better that was until the vasospasm. Oh my god the vasospasm! So I think this was misdiagnosed with my daughter a lot and I have had this previously but this time it was turbo. It was always worse on the right and my entire nipple would go bright white, on a few occasions amongst dark blue.
“Nipple vasospasm is a painful cutaneous vasoconstriction that presents itself with hardening of the nipple and color changes on a spectrum from white to blue to red. Because the innervation of the breast is complex, pain can focus in the nipple or radiate deep into the breast and may last for >30 minutes. The pain often subsides upon return of normal color to the nipple.”
Knowing B’s position could be playing a part in the vasospasm and wanting to get treatment as soon as possible we went to see Liz Gunn a local lactation consultant. She was wonderful and assessed B’s body position making sure he wasn’t finding it hard to move his body in to position and then of course watching us feed. We made some tweaks to my positioning mainly to save up upper back and stop me leaning forward so much (IYKYK.) However the vasospasm continued and still continues to this day at times. Some causes of Vasospasm include:
Hyperlactation,
Breastfeeding with inadequate positioning
Environmental temperature change (to cold) Anderson et al (2004)
Anxiety and Stress
Alcohol consumption
Raynauds Phenomenon
Lack of sleep (show me a new mum who’s well rested.)
Vasoconstrictive medication
Nipple Trauma
Personally speaking I do have a touch of Raynauds, My little fingers and tips of my index fingers go completely white and are painful when I get cold. I think a combination of nipple trauma, a naff latch at times, some serious sleep deprivation and anxiety were on my bingo card for nipple vasospasm. So I tried my best with wheat cushion boob warmers that go in the microwave, tried to chill out and get some rest when I could. As much as I was able to, I insured B’s latch was deep as possible. The treatments for nipple vasospasm are listed below, if I’m honest and had my time again I would try a course of nifedipine.
“A more recent Cochrane meta-analysis concluded that calcium-channel blockers reduced the frequency of attacks by around 1.7 attacks per week. Nifedipine is currently considered the first-line drug treatment for RP and the vast majority of reports of treating nipple RP have used nifedipine.”
Milk Blebs
Thankfully I only had one milk bleb on my left nipple that appeared when I was staying at my mums, I probably shouldn’t have but I actually googled how to get rid of it as I was at my whits end with discomfort and had no idea what to do. So again this is not medical advice, but I basically used water as warm as I could handle, in a shot glass with sea salt and sat with it on the area for 5 minutes, and it (very surprisingly) did the trick. That was a fun day day at mums. I’d always suggest seeking medical advice and not Dr Google, I think I got very lucky.
So without reliving the argument I got in to with a pharmacist, who’s no longer public facing (thank the lord,) about nipple thrush and oral thrush being over treated, I can honestly say this time around I’ve been much better able to advocate for myself and my baby. We did get treated for thrush twice and let me tell you, getting that medication into babe four times a day was no joke. The way we got better within a day was such a huge relief (always complete the full course of meds obvs.)
This time around, I did call the GP when I thought things were going south and I didn’t take no for an answer. I find my favourite trick is to turn up at the GP surgery with a screaming baby and they tend to listen. All jokes aside this leads me on to an important point. Through these last 18 months, support has been absolutely vital for me to be able to continue feeding. From my husband to Liz our lactation consultant, our tongue tie practitioner and lots of wonderful mamas I’ve met locally. We have a fantastic resource in Exeter The Baby Room with wonderful Jen who is a breastfeeding guru. Women supporting women through this is so vital. If you’re planning on breastfeeding have a list of healthcare professionals who can help you. 3am is not the time to be on the internet trying to find the number of a local craniosacral therapist!
Well 18 months in and we’re still here, I don’t know when our feeding journey will end, I’m only feeding once a day before B goes to bed. I really cherish that time, I look at his eyelashes, his feet, listen to his breathing. I think about how far we’ve come and how proud I am of myself, that I managed to get this far. It’s a completely different experience to my daughter, I feel like I had to fight so much to keep going. But we did. As always listen to your gut feelings mama, you know what’s best for you and your babe, always. Big love, V x.
References
-Mitchell BK, Johnson HM. Breast conditions in the breastfeeding mother. In: Breastfeeding: A Guide for the Medical Profession, 9th Ed. (Lawrence RA, Lawrence MR. eds.) Elsevier: Philadelphia, PA; 2022; pp. 552–593.
- Anderson PO. Drug Treatment of Raynaud's Phenomenon of the Nipple. In: Breastfeeding Medicine. 2020. https://doi.org/10.1089/bfm.2020.0198 : Vol15No11.
- Anderson JE, Held N, Wright K. Raynaud's phenomenon of the nipple: a treatable cause of painful breastfeeding. Pediatrics 2004;113(4):e360–e364;