Advice on nipple blanching?

1

Can anyone give me any advice on preventing nipple blanching?

Having read Smarties' thread on BFing, i've googled nipple blanching and I am pretty sure this is what is happening on my left side.  The tip of my nipple is white after a feed and has a crease across the middle of it.  During the feed I feel a bit sore, but nothing too bad, but afterwards I get a burning sensation in my nipple which lasts quite a while and often the nipple is still sore by the time I am due to feed from that side again.  Am not having any of these problems on the other side.

I've read some info on Kelly mom but didn't find it very helpful when it comes to rectifying the problem.  How do I correct his latch?  We do the same thing each side and it certainly looks the same each side, but clearly it isn't!

Can anyone hhelp?

Well all I can give you is my experience and the advice I received. It is about being really careful with his latch but if you feel like you have a pretty good latch then it might be that A is claming down on your nipple during the feed to try to slow the flow of the milk.

I'm pretty sure that's what Noah was / is doing to me, but like you, only on one side now. I was having it on both sides but strangely one side seems to be fine now and the other is only very slight now, where it really was quite painful for a while.

I think the problems for me started around 10 weeks so we have had almost 6 weeks of it - that's not what you want me to tell you is it? I read the information on kellymom too and didn't find it terribly helpful for that. Someone told me that if it is due to the speed of milk flow there's sadly not a lot you can do about it. If it is to do with the latch then you might be able to rectify it.

Oh I meant for that all to sound more positive, sorry. I will say it got a lot better now to the extent that it is pretty much resolved now, if that helps?

Xx

That's all very useful Smarties - thank you.

I've just read that letting the nipples get as much air as poss is good so am currently sitting here with my t*ts out!   Thank goodness MIL and SIL have gone home!

Austin does clamp down on the nipple, he does it both sides, but I *think* he does it more on the left than the right.  I'll have to keep a close eye on exactly what he is doing so that I can get as much info as possible, to try and work out what the actual problem is.  I am sure its either a bad latch or fast let down rather than anything like Raynauds, its just a case of working out which.  Sometimes he seems to clamp down and pull backwards before I even feel my milk let down, so i'm not sure if its that.

How do you know if the let down is too forceful?  Other than if baby clamps down?

I doubt it Raynaud's as you would find it particularly bad in the cold weather, and would probably have had it before. this is definitely related to feeding for me.

I can now tell when my milk comes out as my boobs start to tingle just as the milk starts to flow faster. I think milk comes out straight away from all boobs (someone gave me the tap analogy whereby water is always there, just the flow alters) - it has taken me a while to recognise it though.

N faffs a bit on my right boob until the milk flows faster and then as soon as it starts he sputters and gulps a bit more so I can see that he is struggling more - does A do any of that?

Yes yes YES!

He is really faffy latching onto the left side compared to the right.  I actually have a much stronger physical sensation during the let down on the right hand side than the left, but he does seem to start clamping on the left after I feel the let down (although sometimes before I feel it as well).  He doesn't splutter or choke at all, but I do hear him gulping quite rapidly, although I hear this on both sides (I think - am going to be paying much closer attention!)

Actually, over the last hour i've been sat with boobs out and the blanching seems to be happening even without him feeding.  I suddenly feel the burning sensation in my nipple and will look and find it has white patches on it, then a few minutes later the pain is gone and its all pink again.  Then 15 minutes or so later the burning comes back and the white patches will be there again.  Is that normal?

I think it varies from person to person, but that's certainly what happenns to me. I get the blanching just after a feed and then it subsides, but cna reappear and subside several times between feeds.

Someone told me that warm air helps the bloodflow to the blood vessels and turns them pink again. I did find that breathing warm air onto my nipple ends helped a bit, though is not the easiest thing to do and H did find it hilarious watching me breathe heavily into my bra

You sound exactly like me, I'm sure it was Noah's latch that was the main problem, added to the clamping. It does seem to have all but gone now though, so there is light....

I also find that Noah breaks suction with my breast when the milk is flowing the fastest. He doesn't come off the boob at all, but I can hear him lose suction and then next time he sucks he has to draw the nipple out all over again, and that certainly added to the soreness.

Gosh Smarties I think I you!  So nice to hear someone else say "yes - that's what happened to me too!"

Have got my plan of action:

Am going to keep a much closer eye on what is going on so that I can talk to MW next week about it.  In the meantime, I'll try feeding slightly reclined so that gravity will help if the flow is too fast, am also going to get Mr S to help at the beginning of feeds as I feel that I need an extra pair of hands.  A couple of things that I have read about ensuring a good latch is to make sure baby's mouth is wide open - Austin doesn't always open his very wide, but I usually manage to hold the breast above the nipple and kind of fold it in .  Apparently this isn't so good as it teaches baby that they get fed even if they don't open their mouth wide, so you should not put the nipple in their mouth until it is wide so that they learn they only get food when mouth is wide open.  And to get them to open wide, use a finger to put a little bit of pressure on their chin (this is where Mr S comes in!  Am too busy holding boob, Austin's head, and tucking his little hands out of the way as he pushes my boob around and often pushes it out of his mouth just as we are about to latch! arrghhh!!)

So operations"Stop the blanching" is underway.....

Thank you so much for your help

Yes you need about 5 hands to cope with all the things you need to when feeding don't you?

I found that N's latch improved vastly when I stuck to my guns and didn't just give in to end the fight as he never opened his mouth very wide either. He did start opening wider after that but still not great, I do think age and mouth size has done me a favour really.

I know DDL has Raynaud's so if you wanted to rule that out she'd be able to help you, but I think that's unlikely.

I tried feeding uphill aswell and it helped a little I think but was a bit awkward. With Mr S's help though you should do well, and your plan of action sounds excellent I think.

Let me know how you get on.

Please please please PLEASE talk to a specialist BFC rather than the midwife. Midwives are great but aren't often trained as BFCs and aren't always able to help - plus you don't want to wait until next week. It needs fixing now.

There are some tricks to getting a good wide latch but a BFC can talk you through those. Call the National Breastfeeding Helpline now to get some advice. 0300 100 0212. They'll be able to put you in touch with someone locally.

Thanks for the number Hazel, very useful!

I have an Independant Midwife who has specific training in breastfeeding (one of the reasons why I chose her, as I had terrible problems before, and very little support!) and am seeing her on Monday so probably not any quicker than I could see a BFC anyway.  I also have access to her 24 hours a day until I am discharged, so if things get any worse and it is affecting feeding I can call her, even if its the middle of the night!  Don't worry, things were so bad last time, I absolutely refuse to let problems get in the way this time and will seek out ANYONE that can help if needs be!  If MW can't help on Mon she will probably be calling the BFC herself - she's very good at calling in reinforcements if something is beyond her knowledge/experience.