by Shari Criso MSN, RC, CMN, IBCLC

This post made possible by the support of EvenFlo Feeding

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Dear Shari,

Help! I’m 8 weeks postpartum with my third child. It was also my third C-section and the third time I’m breastfeeding exclusively. I’ve been having dizzying migraines that sometimes blur my vision, make my ears ring, and make my head feel like it’s in a fog. My OB recommended an excedrin migraine or a little caffeine. That doesn’t often help and I don’t want to take an excedrin or two daily. I’ve gotten the depo shot two weeks ago, and the migraines are still unrelenting. Is it hormones like everyone says? Is there something I can do to help control them or relieve them?

Dizzy Mama

Hi Dizzy Mama,

I am sorry to hear that you are suffering so much at a time when your full focus should be on caring for and enjoying your new little one!  As someone who has migraines myself and cared for many women who have also experienced this debilitating condition, I truly feel your pain.  It is not an uncommon occurrence affecting up to 17% of women of childbearing age.  Migraines tend to get better during pregnancy, due to the high estrogen levels.  Although this is not always the case.  Non-pharmacological treatments should be the first choice when treating anything whether you are pregnant or breastfeeding and can be quite effective. Keeping a “headache diary” can help to identify triggers and make lifestyle changes that will work. Unfortunately, some of the things that do trigger migraines are the norm for any new mom such as not eating regular meals or getting good sleep, however knowing this you can make an effort to take care of yourself as well as your baby.  Something that we as moms can forget quickly!  Caffeine can make a big difference in the effectiveness of migraine treatments and is generally safe to use in moderation and as long as it is not affecting the baby.  Excedrin is actually NOT a drug that I would recommend since it contains Aspirin which is transferred into breastmilk.  The baby receives about 4-8% of the mother’s dose.  Breastfeeding women are advised not to use aspirin because of the risk of Reye’s Syndrome in their babies.  As for what prescription medication to take, Imitrex is generally considered safe for breastfeeding as the infant will only receive about 1% of the maternal dose and it is cleared quickly out of the milk.  No short-term problems or long-term developmental issues have been documented in breastfeeding infants exposed to these drugs.  Of course you will need to consult your doctor about this or any other medication, as well as to obtain the prescription.  If your OB is uncomfortable due to lack of experience or knowledge, maybe it is worth seeking a second opinion.  I hope this helps and that you have some relief quickly!

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Dear Shari,

My daughter is 16 months old now. Lately my nipples feel so sensitive and sore and I’m not sure why. I think she may be teething, cutting her molars now, could that be causing this pain? What can I do about it? My plan was to let her self-wean but right now I wish we were done. I don’t want to give up on my goal yet though, how can I get through this and how long will it last?

Feeding a teething baby

Dear Feeding,

Congratulations on your great success breastfeeding!  Yes, it is possible that her teething is causing her to clamp down while nursing and causing your nipples to feel sore. If that is what is happening, it is important to pay attention to when she is done “eating” and to remove her off your breast before she has a chance to bite down or rub against your nipple trying to soothe herself.  You can also offer her a cold or frozen washcloth or teething ring to chew on so that she is not using you!  The other thing that I was thinking as I read your question…is to take a pregnancy test   This is actually the very first sign for most pregnant moms!  Nipple pain and soreness all of a sudden after many months of pain free breastfeeding (in the absence of any infection or damage to the nipple) can be the first sign that you are expecting again and it is worth ruling that out first with a pregnancy test.  If the soreness is due to pregnancy, there is not that much that can be done about it since this is hormonal vs. mechanical or technique.  For many nursing moms who become pregnant this is the main reason that they decide to wean their older child, but for others it is not a problem and they can safely continue throughout their pregnancy and beyond to tandem nurse their children. Keep me posted!! xoxo

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Dear Shari,

I have a sort of white dot on the tip of my nipple and it is extremely painful when my baby is latched on that breast. It’s been there for a couple of weeks now, it looks sort of like a pimple. I tried squeezing it but that just hurt more and didn’t do anything. My baby is just 7 weeks old and the idea of this pain lasting until we’re done breastfeeding is so discouraging. Help!

Owie Nipple

Hello Owie Nipple,

I am glad you wrote in to ask this question because it is a fairly common issue that moms will encounter.  It is called a “milk bleb” or a blockage of milk inside one of the nipple pores where the milk comes out of the nipple.  That is why it is white.  A milk bleb is not serious condition, but can cause serious pain in the nipple especially when trying to nurse or pump.

The best way to approach this is to first not wait to do something about it. Left untreated it can cause your breast to become engorged which can lead to a decrease in your milk production as well as mastitis.  The first thing you can try is to soak your entire breast in a bowl of hot water.  Fill the bowl with water and then lean over it and just soak for 5-10 minutes or longer.  Immediately try to nurse your baby or pump after that.  The water will often soften and loosen the plug and it will be sucked out by the baby!  It is perfectly fine for them to swallow.  You may notice after nursing that it is starting to come out.  If you can you can pull it out, but I would not squeeze your nipple to try and “pop” it.  It is not a pimple and squeezing your nipple can cause more inflammation.  If the soaking and suction does not work you may need medical help from your doctor or midwife who can use a sterile needle to remove it.  This is not something that I would do at home (although I know women who have) due to the risk of injury or infection.  Good luck!

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Thanks for EvenFlo Feeding, Inc.’s generous support for families in the their feeding journey.

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For over 23 years, Shari Criso has been a Registered Nurse, Certified Nurse Midwife, International Board Certified Lactation Consultant, nationally recognized parenting educator, entrepreneur, and most importantly, loving wife and proud mother of two amazing breastfed daughters. You can find her on Facebook or her own personal site.