LC: Fissure

kymberli00

Hi! I have a 6month old. At 2 months, around the same time we weaned off of nipple shields, I developed a fissure. Over the past 4 months, it has gotten significantly worse. I have tried everything I can get my hands on to get it to close with little luck...it continues to get worse.

I am working with a LC so I know my latch is not an issue. I am also seeing a breast surgeon. I saw her yesterday and she is asking me to do a punch biopsy of the nipple because it continues to get worse even though we have tried lots of products, creams, ointments, etc. She is worried there's a bigger issue...

I am very worried about going through with this biopsy since it may end my current nursing relationship and prevent me from any future ones with future children. 

Questions:

What advice would you give to help heal a severe fissure (essentially is just an open sore at this point but I can still painfully nurse on that side and have been)? 

What is the likelihood of this biopsy interfering with my ability to nurse for this child and future children? I have gotten conflicting answers so just trying to get as many opinions as possible!

TIA!

DeirdreIBCLC

Hi Kymberlie,

So sorry you're going through this.  What a journey.   

About wound care, I doubt I can add anything if you've had a good LC working with you - my recommendations for wound healing are always any/all of the following ..

salt water rinse, soap/lather to keep clean (non antibacterial, non-perfumed soap), breastmilk applied after feeding, air drying/keeping nipples clean, moist healing (Soothies brand or Comfortgel), APNO, assessing mother diets/gut, allergies, yeast assessment, ice/Ibuprofen as necessary for inflammation.

I know there are further wound care options out there including healing that happens for folks with deep, profound wounds that include other gel pads with medications, including silver ... but I believe there is still caution with those in terms of being so close to your breast and transferring to baby.  A recent conversation on one of the IBCLC yahoo groups I am on was just discussing this.  Maybe ask your your LC if she's heard of MediHoney - I know this one is used in breastfeeding care/wound healing.  

As for post biopsy, I am going to have to admit I am not well versed on the subject of predicting breastfeeding after surgery.  My understanding is it would depend on where the biopsy is, how deep, how much tissue and how it effects your glandular tissue/duct work.  Definitely questions for the surgeon. Sorry I'm not more help there.  

Best healing vibes to you!

Warmly,

DeirdreIBCLC 

coey03

Just curious. Were you prescribed APNO? I was on that too long, so my fissure could not heal due to the steroid.  The midwives didn't consider that the prolonged steroid use would cause skin break down. Once I stopped the APNO, it was able to heal with the salt rinses. GL!

kymberli00

Thank you all for your input! I have tried APNO, quit it months ago. I know it inhibits healing at times.

I have had cultures done...yeast and bacteria negative. 

The punch biopsy will be done tomorrow. She is suspicious of Paget's Disease of the Nipple. I have all of the symptoms but do not fit the "normal" profile (women in 50s). 

I have not tried silver cups but I have done soft shells...sounds similar...but I need airflow to it or it gets real itchy.

Biopsy results should be back by early next week. Obviously, praying that it comes back negative for Paget's but they just are not sure what else it could be...it's not a fissure at all any more. I have taken photos randomly to keep my LC in the loop and the progression of it is pretty interesting...I never realized until I compared them all  

sofia8079

I have a friend that just bought Silverette USA on their website. She told me they are now available in the US....I used them myself (I bought them in Europe) after I had my baby and they are magic...

bingbongsmama

I agree with APNO or tripple nipple cream, it's fantastic.

As far as the biopsy, it will not prevent you from nursing in the future. I know because I had a breast biopsy when I was about 13 months into EP for my first baby. I found a hard mass which turned out to be benign,I continued pumping until she turned 2 and now pump and nurse my second baby.

StephandMatt2012

Is it possible to stop nursing on that side ? And just nurse on the good side, you can EBF with one breast if needed, I had to do that for two months I had a major wound on one side and just stopped feeding until it healed then got him back on that side and supply just adjusted.

TheAnalyticalMommy

I know this doesn't really compare but when I first started nursing and was bleeding, what helped me heel was to feed the baby a bottle of pumped milk and just pump for a few days. I think it let me keep the nipples drier longer than if i had been nursing him... not entirely sure but maybe pumping on that side exlusively for a while would help. 

 

Good luck!

Juliamommyny

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