NIPPLE PAIN WITH EVERY BREASTFEED AND VASOSPASM: Christine and second born 4-week-old Jack. Dr Pamela Douglas Masterclass 28 February 2024
Christine wrote in an email prior to the consultation:
My boy Jack is 3 weeks old (DOB 31.1.24) and since day 1 I’ve had painful feeds. He’s my second baby. He compresses my nipple (pinching) and despite lots of LCs, osteo, the online Robyn Thompson method and 2 paeds review I am still having pain with every feed and nipple vasospasm.
Main causes suggested have been oversupply and fast letdown (true)- so I compress before every feed and the other suggestion is posterior tongue tie (very controversial I understand)! No improvement and no plan really from here.
I would love some support to continue breastfeeding without pain.
My reflections afterwards
I do like to believe that it's possible to run very effective online breastfeeding interventions, pretty much as effective as F2F. But I confess after working with Christine tonight I reflected that I would have liked to have been in the room with her, able to (with her consent) take the weight of her forearm and physically guide the micromovements. I think she would have been more likely to have had an experience of decreased pain, which then helps women feel empowered to continue experimenting. She did experience increased pain in the consultation, which I guess still demonstrates the power of micromovements - that micromovements impact upon nipple and breast tissue drag, which impact on her pain experience - but I would have liked to have been able to demonstrate that more clearly for her, with a clearer sense of which direction of micromovement was most likely to help.
I wasn't able to visualise the nipple well when it came out of the baby's mouth, either, which is also often a useful indication of what is happening with nipple and breast tissue drag. (If we see the nipple fall down lower, for instance, or swing back towards the midline, it's a sign of the direction of the nipple and breast tissue drag.)
Hopefully the consultation was still useful for her, and that her experimenting with the gestalt method will help her find a way through.
Cheers, Pam