Sore nipples, possibly caused by thrush and donating milk

[sunshine_sieben]

Hi,
I have previously donated milk to a friend of mine who cannot make enough for her baby. But then i stopped for a couple of months as she had enough from another donor.
for the last couple of months I have been battling excrutiating nipple pain. I don't know the reason for it. It is in only one side and I cannot find any symptoms of thrush apart from the pain in me and can't see anything in DS's mouth.
I treated with Daktarin for 2 weeks without any marked improvement.
I did find a crack 2 weeks ago and itt seems a little slow to heal up. i think the crack might have been there all along, but it was in a little fold, so kind of hidden.
To help healing I have cut DS (12 months) down to only 1 feed a day from that side. The rest of the time I am pumping. Unfortunately, he refuses to take the milk.
My friend has run out of donor milk and I would love to be able to give her my pumped milk but am a bit apprehensive as I am not sure whether there is some sort of infection that I might pass on to her baby (6 months) through my milk.

I asked a Bfing councellor at the ABA meeting today and she said she had no idea whether thrush can live in the milk (if it is thrush).

I would love to hear people's thoughts on this, especially if you have any knowledge on this issue.
Would home pasteurisation of the milk make it safe? I am sure she would prefer to give her baby boiled breast milk over formula...

[studymum]

Hi, I don't know about it passing through the milk, but I know it can be passed from mum to bub and back, but whether its through the actual contact I am not sure. Sometimes you need to be treated for internal thrush, so maybe try something like canestan oral?

[Jennifer13]

Are you sure it's thrush? The fact the Daktarin made no difference would make me think it isn't thrush at all.

I don't know if this is the case with you, but my DD damaged my nipple on one side at nearly two and it took months before it was completely healed. It wasn't an ongoing infection or thrush, there were no other symptoms, it was just that her feeding from that side (even only twice a day) was enough to open the wound again every time. I tried pawpaw, which helped, and advanced wound healing bandaids, which also helped, between feeds. I think it was just a size thing for us, the way her teeth rubbed on that spot. It disappeared almost as if by magic, her mouth must have just grown enough to stop irritating the 'crack' (wound).

Taking good care of the damaged nipple in our case definitely stopped it turning into anything worse or getting infected, but it just didn't heal properly for quite a while.

Does that sound anything like what you have?

[black_rose]

It could also vapospasam, it is very painfull and the cold weather can make it worse, try keeping it warm, use a heat pack to see if it helps.

[sunshine_sieben]

Jennifer13, no, in fact I am almost certain it isn't thrush. But the possiblity is there and i would hate to pass it on to another bub.
Actually, your situation sounds exactly what is happening here. Except it started before DS had any teeth. I had a few sore nipple episodes with DD, usually when she changed attachment due to teething pain. But usually this resolved after a day or two of pumping and not feeding from the affected breast.
The breast feeding councellor suggested that the fact that the crack does not heal up easily points to a possible infection of some sort. She also said that sometimes you need to treat the nipple and your baby for weeks and weeks to get rid of thrush (if that's what it is).

Black_Rose, I'm sure it isn't Vasospasm. Cold temperatures do not bother my nipples at all. In fact, I can switch from hot to cold showers without any problem. Also, I would find it strange for this to suddenly show up after over 3 years of breast feeding and only on one side.

Studymum, I think you are right. If the infection gets into the breast tissue, it might be much harder to get rid of. I'll be talking to my GP on Friday and see what he thinks. I know that yeasts go dormant when freezing, but they don't die. And I guess since yeasts usually feed on sugars, the lactose in the milk would be a good environment for them. But from the research I have done, it is not known whether it can be passed on through the milk only (rather than contact), but they usually advise to exercise caution.

Thanks to all of you for sharing your thoughts. I gave her my milk and told her to scald it to kill possible infections until I have the all clear.

[Taurean]

It could also vapospasam, it is very painfull and the cold weather can make it worse, try keeping it warm, use a heat pack to see if it helps.

Exactly what I was going to suggest. I was diagnosed with vasospasm when DD was about 10-12 weeks old. I had been treated for thrush twice (I honestly think I did get thrush twice though) but when the pain continued and got worse, my GP just kept on treating it as thrush. I was in agony, even when I wasn't breastfeeding. Cold temperatures made it worse too. If the breeze was cool on my face, my nipples would ache/sting - I can't find the right word. It hurt like hell anyway!!

My LC finally diagnosed it and suggested I go on medication if I wanted to continue BF. I can't for the life of me remember the drug I was prescirbed but it's for high blood pressure. Anyway, after a few days the pain had almost gone - I couldn't believe it! Within a couple of weeks, I was completely pain free. I continued to take the medication until DD was about 5 months old and I've been pain free since.

I suggest discussing this with a LC, hopefully they can help.

ETA: sorry, just read your last post. It would be unsual to get it in only one side but it can happen. Also, it often occurs in damaged nipples so maybe all the expressing is to blame. That was the case for me anyway.

[sunshine_sieben]

Taurean, thanks for sharing your experience. but i honestly don't think that this is what's happening. As I mentioned, i can switxh from hot to cold showers back and forth without any discomfort. I also don't think that pumping is making it worse as pumping does not hurt at all (although I do pump a little carefully as I don't want to aggravate the crack).

ETA: Oh, and this problem started when I wasn't donating milk, so I wasn't pumping at all. I am only pumping again as I don't want to feed from that side until it is healed. DS won't take expressed milk, so I thought I might as well donate the milkto a mother I used to pump for a few months ago.

[Taurean]

No probs! It sounds nasty. I'm pretty sure the cold temps is a *must* with vasospasm but maybe just check our nipple after a feed. Does it turn white? That's another sign. It does sound unlikely though.

Thrush should have cleared up with Daktarin. Maybe the nipple is simply damaged somehow. I'd highly recommend getting a LC to have a look at it. I saw several GP's that kept on treating me for thrush, only my LC knew what was really wrong. Even when I went back to my GP to get the script for my medication, they claimed they'd never heard of vasospasm

LC are brilliant with all things nipples, LOL

[MantaRay]

SS, I am not sure what could be causing your pain, but it is most likely going to be either thrush or a breast infection. The question about whether your EBM would be ok is not a yes/no answer. It is believed that some thrush passes into EBM, but it is in just a small amount that it wouldn't affect an otherwise healthy baby. Thrush is everywhere all the time, we all have it on us, so babies are constantly exposed. It becomes a problem if they (or we) get exposed to enough of it or get run down enough for it to take hold. If you ask enough professionals you will get some saying yes it's fine and other's saying it isn't. It's really your call and your friend's - but remember the anti-infective properties breastmilk has also!

[sunshine_sieben]

Taurean, you are right about getting a LC to look at it. That's why I went to the ABA meeting. (although as far as I know they aren't certified LCs).

Mantaray, Thanks for the info. I have just left it up to her. I told her about my issues and told her that it MAY be an infection or thrush, but it is up to her whether she wants to use the milk or not. And whether she wants to scald the milk (killing the immune supportive substances, but also yeasts). Totally her call.