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Symptoms Of Canker Sores
Canker sores are small mouth ulcers that can cause great deal of pain and discomfort. They are not cancerous and are usually associated with trauma or injury to the inner linings of the mouth called the mucosa that gets infected by bacterial invading the breach in the protective layers.
What is a canker sore?A typical canker sore is a small ulcer within the mouth. It is commonly noted at the base of the gums, the insides of the cheeks, the soft palate (back part of the roof of the mouth), over the tongue, inside the throat or on the insides of the lips.
What do the lesions look like?The lesions appear white or yellowish in color and have a cheesy base that signifies the ulcer. There is a raised red edge that may be swollen.
There may be a single localized sore or numerous sores in the mouth.
How many canker sores occur together?Commonly 2 to 3 canker sores appear at one instance. However, in some individuals there may be 10 to 15 ulcers at a particular attack.
How do canker sores begin?The sores begin as red spots or bump and go on to develop into an open ulcer. The canker sores are preceded by tingling or burning for a day before they appear.
How big are canker sores?The sore is usually a small one with less than 1/8 to ¼ inches in diameter. Those that are major ulcers may be 1/2 inches in diameter.
Sores are most often roughly oval in shape. The whole lesion is excruciatingly painful especially the initial 7 to 10 days making it difficult to eat or speak.
Healing of canker soresThe sore may turn grey just as it begins to heal. Some patients may have other symptoms like fever, general feeling of unwell and swollen lymph nodes.
The pain recedes in a week or 10 days and the ulcer takes around 1 to 3 weeks to heal completely. Large ulcers can take longer to heal.
Inheritance of canker soresAround 40% of the patients with canker sores have someone in their family with the condition as this condition may be inherited. Canker sores however do not spread on contact and are not contagious.
Recurrence of canker soresIn some individuals the sores may recur frequently. Attacks may vary from one sore every 2 or 3 months or even continuous presence of canker sores at various locations within the mouth.
Recurrence at the same area may indicate a repeated trauma with an ill-fitting denture or with a sharp edge of a tooth.
Therapy for canker soresIn most cases the canker sores heal without any therapy. However, since they make intake of food and nutrition difficult, these factors need to be kept in mind. Especially in children with canker sores nutritional maintenance is important.
Canker sores and more serious pathologiesDuration of the canker sore is important as longer lasting sores may be indicative of more serious pathologies like oral cancers. History of smoking, chewing tobacco and alcohol use is also important in these cases.
In addition, if there are features of fatigue, abdominal pain, fever and loss of body weight and appetite over a period of time a more serious diagnosis is considered and the patient is evaluated. Eye discomfort, rashes or sores over other parts of the body also indicate other underlying pathologies.
Three types of canker soreCanker sores may be of three basic types:
This is seen in more than 80% cases of canker sores. The sores are less than a diameter in size. These sores take around a week to heal completely. There is no resultant scarring after the sores have healed.
This is a more serious form of canker sores. It affects around 15% of all sufferers. These sores often last two weeks or more. They are usually over 1cm in diameter. They can be extremely painful and may leave behind scars after healing.
This occurs in less than 5% of the sufferers with canker sores. Sufferers usually get very small ulcers that may be less than a millimetre in diameters in clusters that merge to form larger ulcers. These take a week or so to heal completely. (1-7)
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Common Breastfeeding Problems
Whether you are an experienced mom who has breastfed before, or a new mother nursing for the first time, you may run into a number of common problems.
Although most are not serious enough to keep you from breastfeeding, some can make breastfeeding a more uncomfortable and less fulfilling process for you and your baby.
The good news: Often you only need make a few minor adjustments in technique or style to get your body and your baby in perfect sync. "Breastfeeding should be a pleasurable experience for both mother and baby. If it's not, then it's important to identify the problem early on and make whatever changes are necessary," says Pat Sterner, a lactation counselor at the Mount Sinai Medical Center in New York.
Some of the more common breastfeeding problems - and solutions - follow.
"Many women find that their nipples not only feel sore after every feeding, they are red and pointy instead of round and smooth -- all indications that your baby is not 'latched on' properly," says Sterner.
The "latch" as experts call it, is the way your baby connects to your breast. When done correctly, your baby will open their mouth very wide and take in a good deal of breast tissue. This means that your nipple ends up way in the back of your baby's mouth where the hard and soft palates meet.
"When your nipple is sitting way back there in the hollow, there is nothing to pinch, so it should not cause any nipple soreness at all," Sterner tells WebMD.
If, however, your nipple is sitting in front of your baby's mouth, you're going to feel the pinch every time baby's tongue comes up -- and baby is not going to have an easy time feeding.
The solution, says Sterner, is to insert your finger into the corner of your baby's mouth to break the latch as soon as you feel pain -- and then try latching on again. Ideally, your baby should take at least one inch of your areola into the mouth.
Experts say you can further ease pain by avoiding the use of soap on your breasts, which can be drying and irritating. Instead, wash with plain water. You might also want to let some milk air dry on your breast after feeding, which can help reduce some inflammation and soreness.
To keep nipples soft and supple, try any of the lanolin-based creams specifically for nipple inflammation, such as Lansinoh, Belli Cosmetics Pure Comfort Nursing Cream, or PureLan 100 Nipple Cream by Medela.
Even when your baby is latched on correctly, you may develop a sore or tender spot in your breast, or even a painful lump. Says lactation expert Carol Huotari, this commonly results from a plugged milk duct, or the beginning of an infection known as mastitis.
"Either problem can be easily remedied, and you don't have to stop breastfeeding in the meantime. It's perfectly safe to continue, even when an infection is present," says Huotari, manager of the Breastfeeding Information Center at La Leche League International in Schaumberg, Ill.
If the pain is from a blocked milk duct, experts at La Leche say you should apply moist or dry heat compresses to your breast for 10 minutes, three times a day. Also, massage your breast in a warm shower. As the duct unplugs, you may express some milk, which helps relieve pain. Continuing to feed on that breast is important because breastfeeding helps further open the milk ducts, says Huotari.
Though early treatment will usually prevent a plugged duct from becoming infected, this is not always the case. So if you have pain and tenderness and also find you are fatigued, running a fever, and have some flu-like symptoms, you might have a breast infection.
Normally, says Huotari, the same method used to treat plugged ducts works for an infection -- heat packs, along with bed rest. If your fever does not break in 24 hours, however, you may need an antibiotic to stem the infection. Call your doctor. In the meantime, experts say don't stop breastfeeding.
"Although it may seem counterintuitive to breastfeed while you have an infection, because breast milk contains such a high level of antibodies, your baby is safe," says Huotari.
Yeast infectionis a less troubling but still uncomfortable condition on the surface of the breast skin. This problem can develop even after weeks or months of successful nursing. The culprit is thrush, a form of yeast infection that thrives on milk. This infection will likely affect both you and your baby.
Signs of thrush include red or pink shiny skin that usually itches, and may flake or peel, says pediatrician Audrey Naylor, MD. To learn if your baby is infected, look for white spots on the inside of the cheeks, or sometimes a persistent diaper rash.
You might also find that you have symptoms of a vaginal yeast infection -- a clumpy white discharge and extreme itchiness.
If you do have a breast yeast infection, Naylor says you don't have to stop breastfeeding. But you and your baby do need treatment.
"See your doctor and let her or him make a recommendation for treatment. Don't try to buy a drugstore product and treat the infection yourself," says Naylor. While some products are safe to use while breastfeeding, others are not. Only your doctor will know for certain what is right for you and your baby.
Engorgement is normal and can develop when your milk begins to flood your breasts, usually between the second and sixth day after you start nursing your baby.
"Once milk starts to come into the ducts, there is also a flooding of lymph fluid and blood, which causes the tissue in the breast to swell," says Sterner.
Because that swollen tissue pushes down on the milk ducts, the ducts can sometimes clamp shut. When milk can't be expressed, it builds up inside the breast and engorgement occurs.
Sterner says your best solution is to place cold packs on the breast, along with clean washed cabbage leaves. Leave these on your skin for about 20 minutes. Both can help reduce the swelling and allow the ducts to open.
"Right before you are ready to nurse, put a warm pack on your nipples for a few minutes -- this will also help with the 'let down' [milk flow] and can encourage feeding," says Sterner.
Showers are not recommended when you have engorged breasts, warns Sterner. The warm, pounding water can dilate blood vessels, increasing the swelling and congestion in your breast.
"Most important is to keep on nursing," Huotari tells WebMD. "The more milk that is expressed, the less chance you have of engorgement."
Nursing mothers are often surprised to discover how little their obstetrician or pediatrician knows about breastfeeding problems. Lactation consultant Katy Lebbing, IBCLC, says that as recently as the mid-1990s, a full 50% of medical schools were graduating doctors without a single day's training on breastfeeding.
In one study published in the American Journal of Preventative Medicine, the obstetrical staff of a California hospital answered just 53% of the questions correctly on a simple 15-minute quiz about breastfeeding. Only 14% of the doctors said they felt confidant about their knowledge on this subject.
If you have questions concerning any aspect of breastfeeding, including medical issues about your breast health, you'll often get the right answers fastest by contacting a lactation counselor.
Usually, the hospital where you delivered your baby will have at least one lactation counselor on staff. This counselor may have even visited you shortly after you gave birth to help you begin breastfeeding.
Most lactation counselors are also available for at-home consultations after you leave the hospital. If this isn't the case, they can suggest private practice lactation experts to help you.
Although many people experienced with childbirth, such as doulas and midwives, may be able to help you with breastfeeding, try to find lactation consultants with the initials IBCLC after their names. This stands for International Board of Certified Lactation Consultants.
An alternate credential is RLC -- for registered lactation counselor. Both credentials mean the counselor has received special training and has certified expertise in breastfeeding.
The following organizations can help you find a lactation counselor in your area:
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