Saturday, February 12, 2011

Raynaud's of the nipple

For those not interested in the details of breastfeeding problems, you may want to skip over this. I’m putting this out there for the new mothers who will come after me, spending their few spare moments googling for help/information/advice. Perhaps something I learn along the way will be useful to someone else.

There is a helpful article here about Raynaud’s phenomenon of the nipple, one of the other fun breastfeeding challenges I’m facing. I’m pretty sure I had this with River too, as I distinctly remember it being painful to go outside in the winter, though no one diagnosed it then. This time, a lactation consultant identified it when I mentioned turning back from a walk because my nipples hurt too much to continue on.

Until now, I’ve been focusing on trying to get rid of the thrush, hoping that the Raynaud’s would go away as a result. But a new lactation consultant said I should go after the Raynaud’s first. The consultant I’ve seen most often is mystified that my big crack has still not healed after six weeks. The new consultant suggested that perhaps the constriction of the blood vessels are preventing blood flow to the nipple, which is preventing the crack from healing. If I can heal the crack, I’ll eliminate the open portal that makes it very easy to transfer yeast and bacteria. So yesterday I got a prescription for nefidipine.

My ob/gyn had never heard of the use of nefidipine for Raynaud’s, though he uses it regularly for pre-term labor. However, he said it’s a safe drug and unlike other doctors I’ve come across, seemed to respect the opinion of the lactation consultants. So he prescribed it without hesitation.

The bottle said that the medication should not be taken in conjunction with grapefruit, so I gave the pharmacist a call. I’ve been using a lot of grapefruit lately in trying to battle thrush – 750 mg of grapefruit seed extract tablets, grapefruit seed extract applied topically to the nipples and I eat a grapefruit every day.

The pharmacist said that grapefruit can magnify the potency of the drug, up to 50%. She said that since my dose wasn’t too high, a 50% increase wouldn’t be toxic, so it was up to me whether or not I wanted to continue with the grapefruit.

I must have had a lot of grapefruit in my system, because I could immediately feel the effects after the first pill. My cheeks became flushed, I felt a rush to my head and I could literally feel my blood vessels expanding in my legs. I also had a headache for hours. It was pretty surreal. However, with only one pill so far, my nipples are doing much better. I’m going to try it for two weeks or so and see what happens.

Crossing my fingers we are nearing the resolution phase!

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