Irritant Dermatitis & Breastfeeding

[Knomester]

So, after 7 weeks of breastfeeding woes, I have been told by the dermatologists who have been treating me for irritant dermatitis that we have reached the end of the line as far as treatment goes. I have to stop using the potent steroid creams tomorrow (having used them daily for 3 weeks), leaving me with only paraffin and novogel pads. The likelihood is that the dermatitis / eczema(which has been maintained, but not improved in the slightest by the steroid cream) will get worse quickly if the irritant (my baby's saliva) is not removed. In other words, if I don't stop breastfeeding.

Having explored all other options, seen 2 lactation consultants, the Breast Care clinical lead at King's and 3 separate dermatologists (amongst others), we are reaching the end of the road as far as breastfeeding goes this time around.

I'm sure this forum knows as much about our sorry saga as my doctors do from my various pleas for help and advice (!), so I just thought I'd try one more time and ask if anyone has had severe irritant dermatitis / eczema caused by breastfeeding and, if so, if you have any advice (other than expressing which is not really an option)?

Please do PM me. Thank you.

[Mustard]

Have you tried pawpaw cream?

[ClareC]

Sounds awful :(

I haven't experienced this but do suffer with sensitive skin so can sympathise. I haven't seen the other threads so apologies if this already suggested, have you considered expressing and bottle feeding?

[Saffron]

Is the eczema suspected to be infected/prone to infection? Have you tried 'bleach bath' treatment? Otherwise, if you've exhausted every combination of barrier cream and nipple shield, I can't think of any other practical way to improve the dermatitis other than to limit contact with the irritant. Could you introduce bottle feeds to cut your breastfeeds to just a couple times a day to keep your milk, but minimise contact with Baby's saliva? :( Hope it all gets better/easier soon. xx

[Knomester]

Thank you all.

ClareC - Expressing isn't really going to be an option long term for me with an almost 4 year old to look after too as the dermatologists have advised that it will take a minimum of 2-3 weeks total break from BFing to start healing and then it will still be an ongoing problem if we start again.

Saffron - The sores (especially on one side) are ulcerated and open. I've been advised they won't heal whilst I continue to BF. There has been no change at all in 3 weeks of festidiously applying steroid and barrier then washing before and after each feed.

I think I'm clutching at straws!!

[Convex]

Really feel for you knomester.

Is it worth posting on a bigger site like mumsnet?

[devsdev]

I'm so sorry - sounds like a really stressful time, especially with an older child to care for and no doubt a lack of sleep.

All I want to say is that formula, if you need to switch, will not do your baby harm. I had to fully FF after 5 weeks with my older daughter because she wasn't putting on weight (many reasons why breastfeeding wasn't properly established) and I was incredibly upset about not being able to breastfeed her and felt very strongly that I was letting her down. I know your reasons are very different, but the emotions about switching may be similar. Our DD is tall, strong, smart and, most importantly, very healthy. For her first year she barely had any colds and coughs and was arguably the healthiest out of 9 kids in our NCT group - all the rest were BF. I'm not saying formula made her healthier - just that it certainly didn't make her unhealthy.

I really hope you find a resolution.

[Crokes]

That sounds terrible. Sorry to hear you're going through this. Have you heard about silver nipple cups to help with the healing? Recommended by a few friends and worth googling in relation to irritant dermatitis.

Good healing and good luck!

[Knomester]

Thank you.

Yes a post on a bigger site like Mumsnet might be useful - I'll try to register and post tomorrow.

I'll take a look at the silver cups too.

[Saffron]

Sorry I don't have time to post more on this, but to aid healing you might want to research this further: http://www.bbc.co.uk/news/health-24940406. Agreed, on a larger website you might find people with direct experience of using bleach baths for eczema and healing ulcers. xx

[Knomester]

Thanks Saffron I will take a look at this.

[Saffron]

Just a note of support to say I hope whatever decisions you've made that things are getting better now. xx

[Knomester]

Saffron how kind of you to think of me.

As it happens I've been meaning to post to thank everyone for the incredibly supportive PMs - I am trying to respond to you all individually, but time as always is fairly elusive!

Thanks to formula and feeding to a loose routine rather than on demand, I managed to carry on breastfeeding exclusively until he was 8 weeks and am still partially feeding now. I've switched two feeds on the worst side to formula and will switch the last of those this week so that I'll be feeding solely from the left and formula. My pain has lessened dramatically so that I am no longer in constant agony (although not pain free yet!). There has been no healing yet although signs of it between feeds so there is hope for when I stop completely, which I will over the course of the next few weeks.

I'm lucky that baby took to the bottle and formula (MAM anti colic bottles with Hipp formula) like a dream and switches between breast and bottle (although latch not as good as it was - he has become a bit lazy...).

I'm now looking forward to a week's holiday in Camber with my family and some much needed relaxation in a couple of weeks' time!

[Saffron]

:)

[n_m_jones]

I'm sorry to hear this. I had exactly the same thing, very severe nipple eczema in the first few months of breastfeeding. It went on for ages and very nearly led to the end of breast feeding which was so very upsetting. I actually found nipple shields and expressing worsened it because of the plastic/latex rubbing the sore skin.

For me, it did eventually heal. Though I had flares in later months whenever my baby was teething. It was the dermatologist at Kings who helped resolve it. I was given a strong steroid ointment. I just wanted to check you've been using enough? I was told to use a whole fingertip length of ointment on each application (that was a really thick layer). As well as using the emollient (epaderm). Then clean it off (with plain water) just before feeds and reapply straight after. For me this meant 8 applications per day. It was betnovate, and it was ointment not cream. After really following this regime for 5 days there was a real improvement. And this was after weeks of messing about with weaker creams or using too little (because no GP ever gave clear direction on how to use creams!). I understand that there is an even more potent steroid if that doesn't work (clobetasol). After the 5 days I stepped down to a less potent steroid until it was clear. Then I used the steroid whenever there was a sign if a flare. Plus I used the epaderm religiously all the time.

The dermatologists are the ones who should know. But maybe there's a thrush infection there too aggravating it further, have they considered that?

I also tried to reduce the frequency and duration of feeds as best I could ie I stopped my baby suckling to fall asleep etc. but I guess that's stating the obvious when you're a sore as I'm sure you are!

I wish you all the best, I know how awful it is to be in such pain when trying to feed. I hope it heals quickly.