nipple, again!

I'm really quite concerned about it, the swelling is much reduced and the
blackness has faded, I've been able to have a bit more of a feel, pain
permitting and there seems to be a hard lump, which I'm fairly sure isn't at
all related to milk ducts, as there is no swelling or anything further back.
I'm also fairly sure this isn't thrush, as I was on a course of fluconazole,
that finished after this nipple first swelled up. I think there probably was
some kind of infection as the antibiotics have coincided with a reduction in
swelling and the vanishing of any redness.

The problem is, what to do next, I could go to my GP, but I'm not sure he
would be any help, he's not an expert on breastfeeding, he is pro
breastfeeding, but he's fairly non interventionist, is very slow to refer on
for further treatments or investigations, whereas I think an ultrasound may
well be the route here.

I fed Ada on the affected side about 2hrs ago and took strong painkillers at
the same time, feeding was fine, but it is really rather unpleasantly
painful now.

Whatever is going on seems to be a non standard breastfeeding problem, but
one assumes it is in some way related to breastfeeding, making it beyond
anyones expertise, or at least so it seems so far. Right now I don't even
know what I want, let alone how to get it, the one thing I do know is I'm
not stopping breastfeeding.

Anne

I wonder if this is not so much a breastfeeding problem as a breast
problem, or an endocrine problem of some sort, like a lymph node? Not
sure exactly how the health system works over there, is your GP a sort
of gatekeeper to you seeing anyone else? What about a gynecologist - can
you self-refer?

If you feel that you need to see someone other than the GP, as it seems
clear you are not getting the answers and solutions you need, can you or
someone else help you really advocate for yourself and push this GP into
a more proactive position? Whether or not it is a breastfeeding problem
per se, it is quite important that it be dealt expediently as you have a
breastfeeding child who is also being affected by lack of action in
getting this situation resolved.

I'd start making a little more noise (maybe more than you Brits are
generally comfortable with!), and insist that something happen before
the end of the week, either an appointment with a machine or a
specialist before end of business Friday. You've been fretting over this
a bit too long. You need an answer now. A lump in breast tissue should
be taken quite seriously, I'd play that to the hilt and add a layer of
concern and guilt over your breastfeeding baby (I don't recall how old
your child is, but I'd infer mine was on the verge of starvation and
emotional collapse at this point!).

Good luck, and keep us updated.

-Karen, mom to Henry 5.5 and William 1.5-


Anne Rogers wrote:
I'm really quite concerned about it, the swelling is much reduced and the
blackness has faded, I've been able to have a bit more of a feel, pain
permitting and there seems to be a hard lump, which I'm fairly sure isn't at
all related to milk ducts, as there is no swelling or anything further back.
I'm also fairly sure this isn't thrush, as I was on a course of fluconazole,
that finished after this nipple first swelled up. I think there probably was
some kind of infection as the antibiotics have coincided with a reduction in
swelling and the vanishing of any redness.

The problem is, what to do next, I could go to my GP, but I'm not sure he
would be any help, he's not an expert on breastfeeding, he is pro
breastfeeding, but he's fairly non interventionist, is very slow to refer on
for further treatments or investigations, whereas I think an ultrasound may
well be the route here.

I fed Ada on the affected side about 2hrs ago and took strong painkillers at
the same time, feeding was fine, but it is really rather unpleasantly
painful now.

Whatever is going on seems to be a non standard breastfeeding problem, but
one assumes it is in some way related to breastfeeding, making it beyond
anyones expertise, or at least so it seems so far. Right now I don't even
know what I want, let alone how to get it, the one thing I do know is I'm
not stopping breastfeeding.

Anne

I wonder if this is not so much a breastfeeding problem as a breast
problem, or an endocrine problem of some sort, like a lymph node? Not sure
exactly how the health system works over there, is your GP a sort of
gatekeeper to you seeing anyone else? What about a gynecologist - can you
self-refer?

I thought gynaegologists dealt with "down there", however gynaecologists are
the one thing you can self refer into. A GP is basically a gate keeper, so
he would have to refer me on.

I'd start making a little more noise (maybe more than you Brits are
generally comfortable with!), and insist that something happen before the
end of the week, either an appointment with a machine or a specialist
before end of business Friday. You've been fretting over this a bit too
long. You need an answer now. A lump in breast tissue should be taken
quite seriously, I'd play that to the hilt and add a layer of concern and
guilt over your breastfeeding baby (I don't recall how old your child is,
but I'd infer mine was on the verge of starvation and emotional collapse
at this point!).

thing is, that the next people to go to would be the "breast clinic" and
that is something I really really don't want to do, I had to go to them when
I was feeding my first and it was a very unpleasant experience, they just
treated me as a timewaster, which was very upsetting considering the scare
we'd just had (suspected abcess turned out to be solid not liquid hence
referal for further testing, along with a family history of premenopausal
breast cancer). So the only think my doctor would do would be refer to them
and there is a 2 week wait (legal maximum). The truth is I'm not far from
the point you suggest I should say I am, baby is nowhere near starving, but
I'm am in pretty severe pain after feeding her each time (3 times a day on
the affected breast) which is stressing me out rather, plus I'm stressing
out about it in general, not because I particularly think it is anything,
but just because I don't know.

I guess I'm going to have to go to the GP tomorrow.

Anne

Anne Rogers writes:

Whatever is going on seems to be a non standard breastfeeding problem,
but one assumes it is in some way related to breastfeeding, making it
beyond anyones expertise, or at least so it seems so far. Right now I
don't even know what I want, let alone how to get it, the one thing I do
know is I'm not stopping breastfeeding.

At our local hospital, there's a breastfeeding clinic, run by a midwife who
"knows everything" about breastfeeding (according to various people I've
heard from including the LLL leaders). So here, what I'd do would be to get
her number and ring her, in the first instance (not waiting for the
clinic). Any chance there's anything similar where you are?

It's interesting that noone here has said "oh yes I had that" though. That
on its own suggests it's pretty rare. My IANAMD guess would be a lump
caused by tissue inflammation/congealed pus/blood that in turn interfered
unluckily with your blood supply and the passage of milk, e.g., preventing
blood that reached the nipple returning easily, hence the swelling and dark
colour (deoxygenated blood); if that's the case, then provided it's not
gangrenous it should go away as your body clears up after the infection.
However, if it were me I'd definitely be trying hard to get someone expert
to look at it! Sorry it's not easier.

Sidheag
DS Colin Oct 27 2003

Sidheag wrote:
At our local hospital, there's a breastfeeding clinic, run by a midwife
who
"knows everything" about breastfeeding (according to various people I've
heard from including the LLL leaders). So here, what I'd do would be to
get
her number and ring her, in the first instance (not waiting for the
clinic). Any chance there's anything similar where you are?

yes and no, there is a clinic, but it's once a week on a Tuesday afternoon,
i.e. today, I couldn't go as I was teaching and given I teach about 10hrs a
year, it's not something I can just rearrange or take time off from. But,
there is no out of hours contact at all, I asked one of the people that runs
it what the route in to breastfeeding expertise was and that was the sole
way. Ironically last night, when I went to the doctors, I should have been
at pilates and there is a lactation consultant in my class (what are the
chances of that? there are literally 100 in the country). I'm also on a
comittee with another lactation consultant, I have her email and probably
phone number if I can find it, but I'm loathe to use it, she's only paid for
4hrs per week and if I do contact her, she almost certainly see me ASAP and
I don't want her to feel she has to do that.

The other alternative is the drop in on Friday, which is more informal, but
there should be one of the same people there, but not always and as it is
Friday, it only leaves me the afternoon to go to my doctor or whatever.

Your explaination basically makes sense. I'm going to sleep on it, I'm
nervous about going to my doctor with this, I might have more idea in the
morning, it may have got better, or worse!

Anne

Anne Rogers wrote:

The problem is, what to do next, I could go to my GP, but I'm not sure he
would be any help, he's not an expert on breastfeeding, he is pro
breastfeeding, but he's fairly non interventionist, is very slow to refer on
for further treatments or investigations, whereas I think an ultrasound may
well be the route here.

I wouldn't assume you need a breastfeeding expert just because it is on
the breast. Also don't jump the gun and think you'll be pressured to
stop breastfeeding and so avoid seeking further treatment. Get yourself
to your GP, if he thinks it looks questionable he'll refer you to the
appropriate course of treatment.

Good luck
Elle