14 July 2016

Breastfeeding Madness

I've written about breastfeeding before, including a recent post on The Mommy-Go-Round. And when I talk or write about breastfeeding I AM INSUFFERABLE!

It's so easy, she said. Anyone can do it, she said.

NOPE NOPE NOPE.

Consider me humbled, crow eaten and in awe of moms who make it through breastfeeding challenges. If I experienced this the first time around and didn't know how easy it is to "open bra, push baby to breast, go back to eating/reading/scrolling" I'm not sure we would have made it to seven months of exclusive breastfeeding, let alone 26 months total! 

Everything went great with Jane (although reading back in the posts I did have a bout of mastitis that I cleared up without much trouble). But for the past couple weeks I've been in the land of eat-your-words, because breastfeeding has been anything but easy.

To start I had a sore nipple, maybe seemed like a milk bleb. I did hot compresses and lots of nursing to get it open, but it kept hurting and last Wednesday night I got the shock of my life when knife-like pains started internally in my breast, basically all throughout the milk ducts, after my last nursing of the evening.

I've done so much internet sleuthing, but it didn't seem like mastitis (no fever/chills) and didn't seem like yeast/thrush because Livia didn't have any symptoms and mine weren't typical and it was only on one side.

I started calling the doctor's office right away on Thursday afternoon after a terrible bout with pain, but because I felt some better when I called on Friday they didn't seem to be in any rush to have me be seen. Then I had to wait over the weekend to come in, and it got worse and worse (a couple hours of level 9/10 pain after each nursing on the right side).

So far I've been to a nurse practitioner (who diagnosed mastitis even without any mastitis symptoms) and prescribed an antibiotic. Then I had a lactation consultation, and they think it sounds more like yeast, and they recommended treating with diflucan. My doctor's office prescribed that, but only one dose, which is what is recommended for a vaginal yeast infection, with a second dose 7 days later.

The lactation consultants all referred me to "Tips from the Trenches," and the handout on yeast (and everywhere else on the internet) recommends a much longer-term dosing (instead of one dose you take a double dose and then one dose daily for 14 days). So far the doctor's office has said "no way" to that and told me to continue the antibiotic (even though an antibiotic can wipe out the good bacteria that can help fight off the yeast organisms).

I also got some advice on a better latch with Livia. She was pretty wild during the consultation -- slipping on and off the breast and chomping more than usual. It's most comfortable when she's calm/sleepy and can just get down to business. But having to TRY with the latch after months of pain-free automatic nursing has been difficult.

But the PAIN has been the worst. My nipple is still sore (got some prescription cream for that now, although I had to ask if that was OK/it was never offered as an option) so nursing/initial latch is painful. But it's nothing compared to the feeling after nursing is done and the yeast starts attacking.

My pain is worse in the mornings after the first feed, although I do have pain throughout the day after nursings. PERHAPS it's because I go so long in the night between feeds (Livia and I like to sleep) and I have been hesitant to nurse on the right overnight because I know the pain will wake me up totally. But tonight I'm going to try and nurse on the right and hope the morning pain is more manageable. I'm also going to take some ibuprofen in the night, which might help.

In my own opinion, not being an MD or nurse, I have a very stubborn and strong yeast infection that will need the bigger course of diflucan. In the meantime I'm trying grapefruit seed extract, taking high doses of probiotics to counteract the antibiotic and still looking for gentian violet locally (as usual if I'd just ordered it on Amazon once I suspected yeast I could have been using it already). For the pain I'm taking double doses of ibuprofen spaced 6-8 hours apart. It doesn't really touch the pain at all, unfortunately.

There's also the risk of re-infection and the breastfeeding literature says baby and mom should be treated simultaneously to prevent spreading it back and forth. So far Livi has no symptoms so her pediatrician won't treat for it. I hope it stays that way, and that if she does get symptoms we can do some gentian violet or similar to knock it out fast. There's lots of extra laundry in that towels and burp rags, baby clothes and bras all have to be washed in hot water with vinegar rinse. All the breast pump parts and any pacifiers/toys that go in her mouth have to be washed AND boiled (daily!). I've already melted some of her best toys doing that, so I've been limiting what I let her put in her mouth to things that are definitely washable/boilable or that I don't care if they get ruined.

I plan to write a Mommy-Go-Round post after all is said and done -- and to eat my crow in a more public way. And I have a lot more to say about the experience emotionally. But in the mean time, that's where I am now.

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