Wendy asks for suggestions for a mother with very painful nipples in the
early postpartum period.
I am not an expert on thrush, but am known for having an intense interest in
nipple pain.
1. Have the possibilities been considered of Raynaud's?
2. Or a remote possibility of Post traumatic shock from a childhood
abuse incident??
3. Has the palate shape been checked, and
4. the tongue and its activity been checked out thoroughly, in case
this is due to a restriction of proper tongue movement with some degree of
tight frenulum??
5. Was the delivery in any way traumatic or rapidly compressive, (as
in a fast labor) to the baby's head, including even lifting the baby out by
C. Section??
I recently helped a mother who had a history with her first child with just
the description you have given. I have her permission to discuss with LN.
She came to see me before conceiving her second child in hopes I could
figure it out. I investigated her nipples and pain threshhold, and taught
her all I could about latching. But her husband called me when the baby was
but 6 hours old. By doing a suck check, and finding my finger beginning to
hurt from the clamping, I considered the fact that she had had a rapid
second stage to her unmedicated birth, and the possibility of the cranial
bones impinging on nerves controlling the jaw and the tongue. I referred her
to a local osteopath for cranio-sacral evaluation. I actually went with her
to observe. This solved the problem by the second treatment, and she went on
to nurse him for 18 months. The same thing happened with her next child,
rapid unmedicated birth, clamping, severe nipple pain, and they knew
immediately to go for CST on the way home from the hospital, and she is
still happily nursing at 4 months.
FWIW, I attached for Wendy a set of thoughts that I compiled after working
in a hospital setting for years. (Contact me privately if you want this.)
Cotterman KJ, "Zone Model" Tool for Assessing Early Nipple Discomfort: Part
2: The Assessment Process, *Lactation Currents, Florida Lactation Consultant
Association Newsletter,* September, 2002, p. 5-9.**
Perhaps the mother would find it possible to use it to help sort out just
what zone(s) of her nipples are hurting, and maybe even the suggestions for
comfort might be of some help. Let us know how this works out for her.
Jean
**********
K. Jean Cotterman RNC, IBCLC
Dayton, OH USA
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