YOUCH! I think I have thrush........what treatment

[ClaireDeTamble]

I had a blocked duct about four weeks ago (blockage on nipple rather than inside) and things haven't been quite right since then.

In the last week I've been getting really painful stabbing pains - like someone sticking a red hot, blunt knitting needle through my nipple and deep into my breast about half an hour after feeding and lasting about 2 hours, although there is a constant undercurrent of uncomfortableness.

I put it down to a cracked nipple at first, but yesterday and today has been total agony. I am avoiding feeding on the affected side as much as possible but need to do so at least once a day otherwise I am getting too engorged (DD is 13 months so not as bad as a newborn).

Dr. Google suggests thrush - although no other symptoms other than the pain (I've never felt anything like it, even when I first started feeding), so off to the docs this morning.

Just wanted to get an idea of the sort of treatment I should be asking for (in case I get one of the numpties). Any suggestions / experiences?

Also, how long does it typically take for the pain to go when treatment starts?

[Drladybird]

Hello, I'm sorry to hear you are in such pain Claire. I have had thrush many times and sometimes had trouble convincing the doctors that this is what I had (no visible symptoms but deep, stabbing pain in the breast). I found the following leaflet from the BFN invaluable for knowing what treatment I should be offered. Definitely worth a look and print it out to take to your doctors. www.breastfeedingnetwork.org.uk/pdfs/BfN_Thrush_leaflet_Feb_2009.pdf
There are also alternative therapies such as grapefruit seed extract which tastes horrible but I think helped me too. Thrush can be persistent so it is good if you can nip it in the bud. Good luck. Let us know how you get on.

[ClaireDeTamble]

Well - I have miconazole cream and fluconazole - although only 7 days @ 50mg rather than what is suggested on the BF Network leaflet (I couldn't print it to take with me) and Nystatin for the baby, so fingers crossed it clears it up.

I had one of the junior docs on her GP rotation - she was nice but a bit clueless - not surprising as I doubt it is a common problem for a newby on a six month rotation. Anyway, explained what I thought the problem was - she examined me and suggested mastitis. I told her I didn't think so because there was no tell tale red spot and I felt fine in myself - no fever or flu like symptoms, just agonising pain about 30 mins after feeding.

She asked on of the other docs for a second opinion. I have seen this doc before and she doesn't fill me with much confidence. She seemed sceptical to it being thrush, but asked me if I wanted to try the cream. I said yes please and pointed out that I would also need something for the baby.

After she left the room I asked the junior doc if I could also have the oral treatment.

She phoned one of the older docs for advice on the dose. It made me smile when I overheard him referring her to the Breast feeding network [hsmile].

So, first dose of fluconazole is taken and first lot of cream applied. Here's hoping it clears the pain up pretty quick!

[ISeeThreadPeople]

I've had thrush a few times and the nystatin stuff was useless for the dc. I had to use daktarin oral gel for them. It is available otc. They do tend to prescribe nystatin first. Think it's cheaper. Keep up the cream for a couple of weeks for both of you. Don't stop because you think it's gone.

And keep an eye on the nappy area. We stopped too soon first time round and dh had the thrush in his gut and he ended up with a scaly, sore, thrush affected bottom. Went back to cream for me, oral gel for him, cream for his bottom and it finally went!

[Drladybird]

Glad you got something but your experience sounds similar to what happened to me. I hope the treatment does the job. I also made sure I was having lots of probiotics to help restore the balance- either by eating lots of yoghurt or taking some solgar pills. Good luck and persist with the doctors if it doesn't clear up.

[monkeypuzzeltree]

I sympathise, have had it 3 times and son is only 17 weeks! Have learnt the hard way, other than the tablets - which only worked when I was on 2 a day, you need the cream and the oral gel. Plus, wash your bras on the hottest wash, wear a new one each day. Be religious about it! To be honest, I've found not wearing a bra at all the best as I was getting too warm inside a bra and breast pads are the worst for keeping a damp environment where the thrush thrives, I just wear vest tops- but then I don't have particularly large boobs so it doesn't matter and it's really helped, I'll do anything to keep that pain away. HTH

[ClaireDeTamble]

Well the tablets and the cream seem to have had quite a rapid effect. DD fed from the affected side last night and this morning and while there was a little bit of discomfort a while after the feed, the excrutiating pain has gone.

She has also managed to drain the breast in question for the first time in a couple of weeks - I presume the yeast infection was partly blocking a duct or two - so relief all round

I will of course continue to take the tablets until the end of the course and use the cream for a couple of weeks, but thank goodness the pain has gone!

[ScreamyShriekyFrightyWoozyWooo]

That's interesting ISeeThreadPeople. My Ds is 7 weeks old and he's had 2 courses of Nystatin that haven't touched the thrush at all. I had Miconozole, which seemed to work on me though. He now has Daktarin gel, and I have Daktarin cream. Hopefully this time we'll get rid of the bloody thrush!

Hope it works for you Claire. It's so painful isn't it?

[ElphabaTheGreen]

Daktarin oral gel (miconazole) is what is advised in that BfN leaflet and it actually specifically states it's more effective than nystatin. If you do want to change, it's available OTC so you don't need to go faffing with GPs who don't know what they're doing again.

[ScreamyShriekyFrightyWoozyWooo]

Just checked and it was actually Clotrimazole I had the first 2 times for my nipples. It really stung when I put it on, which the Daktarin isn't doing. I'm hoping the Daktarin is penetrating into the ducts, as the Locum said it should. HV said it sounded like I have ductal thrush, but when I mentioned that to the locum she didn't sound like she believed that was possible, so wouldn't give me anything except the topical cream.

How have your breasts been this evening Claire? (Not a question I'd usually ask in RL!)

[ClaireDeTamble]

After posting that they felt soooo much better, I fed her yesterday evening off the affected side and it hurt again - not quite as bad as it had been but worse that the previous two feeds.

This morning, there some some nerve firing, but more uncomfortable than painful.

She's still managing to drain the breast and all but one small lumpy patch around my nipple has gone, so fingers crossed it's on it's way out.

I think I'll stick with the Nystatin for now because she isn't actually showing any signs of thrush and she hasn't passed it on to my other side so I am not sure if she has even contracted it, but I'll keep an eye on things and if she shows any symptoms or it comes back I'll get the Daktarin gel. It is Daktarin cream that I have.

Thanks for the advice!