HELP [sad] thrush and cracked nipples!

[Lib76]

i am currently bf my 6wk old DS. all was going well until i got cracked nipples and thrush. got treatment 1 wk ago, daktarin for my and nystatin for him. we had a horrid scare on Friday when my DS vommited a large amount of fresh blood! it didn't cross my mind it was from me as there was never any blood in his mouth after feeding. anyway he was checked out and all was well.

so today saw gp for 6 wk check and she refused to give me fluconazole for the thrush. she told me to give him some bottles to give nipples a rest!!...great advice! we gave him a couple on friday after he was in hospital as i was so sore and distressed, of course he then ended up constipated!

i am trying so hard to get damn thrush cleared and treat cracks (they are a bit better) does anyone think that using lansinoh and daktarin is a bad idea or shoud i still use both! worried that lansinoh is causing nice moist environment for thrush!

any advice would be great!

XX

[Lib76]

no don't think so, what is silverette?

[fishie]

have you any better source of help than gp? sounds as though a bf counsellor could help.

i had cracked nipples and ds used to bring up blood, which was ok i thought because he was getting rid of it rather than digesting. not sure whether that is really correct though.

anyway, some trained advice on your latch and what to do about the thrush would be good i think. [http://howbreastfeedingworks.com/ here] down rhs.

[fishie]

here evem

[WilfSell]

Sorry you're having a hard time: I have been there with both cracks and thrush - unfortunately the thrush can attack when the damage has set in so you're left with both to treat and the lansinoh does create a moist environment which is a problem...

So - have you spoken to a BF counsellor locally or on one of the helplines? Since you have complex things going on it would help you to get some support.

Silverettes are little cups that you place over your nipples after priming them with bicarb of soda. No idea what the science is but they seemed to give me a bit of relief with small amounts of damage. Not sure they'll touch sides with cracks though...

I have had some success treating thrush with grapefruit seed extract - swab both my nipples and baby's mouth with a dilute solution 4 times a day - seemed to make a big difference within two days but obv it is not a licensed medicine so you need to make up your own mind about this: see www.kellymom.com and www.drjacknewman.com for advice on using it.

You could look up one of the info sheets on fluconazole from the BF websites and take it back to your GP. i got it prescribed 4 years ago with DS2 by basically presenting a reluctant GP with the info and saying I would sign something if necessary to say I was the one taking the risk etc.. The reason it is not prescribed it not because it is necessarily unsafe but because babies are too little for drug companies to do ethical and cost-effective testing on.

If you do decide to treat, might be best to treat the thrush first then use a prophylactic/preventative dose while trying to heal the cracks (though check with a BFC cos they may advise to do it the other way round...?)

Jelonet (gauze soaked in vaseline) provides good healing properties between feeds and keeps them moist and covered (lansinoh tends to get rubbed off more easily). But I would think this too will make the thrush worse.

[LackaDAISYcal]

at your GPs advice. That is very disheartening and shows that she doesn't have a very good understanding of how breastfeeding actually works.

Can you see a BFing counsellor to help with your latch? Once this is corrected your nipples will heal very quickly. As for the thrush, is the pain deep within your breasts or have you only got evidence of the thrush on your nipples? If deep in the breast the pain usually starts towards the end of a feed and continues for around 20 mins afterwards.

If your GP won't prescribe it, you can buy fluconazole tablets over the counter (independant pharmacies sell 150mg ones for around £5, as opposed to £10 in Lloyd's or Boots or £13 for Canesten) or on the internet.

[LackaDAISYcal]

PoP, the BfN have taken the thrush leaflet off their site now as oral daktarin is no longer recommended for babies under four months.

It is being revised at the moment, but i found this with the daktarin stuff blocked out

[[http://www.breastfeedingnetwork.org.uk/thrush-and-breastfeeding.html this os from their thrush part of the site as well.

[pobletsmum]

I was about to suggest trying Daktarin Oral Gel (DD got through at least 3 large tubefuls in her 1st few weeks of life!!!) but have just read LackaDAISYcal's post . Be extra careful with hygiene - use extra hot wash when possible; iron bras & other things that can't go in hot wash. Be super-careful with sterilising bottles etc. as thrush is very resistant. Milton works well to kill it.

I agree that you should present your GP (or a different GP if poss) with the BfN Thrush leaflet - it gives details of doses & everything. If you do end up taking fluconazole, make sure you get a 'loading dose' as per the leaflet.

WilfSell - my understanding is that fluconazole is licensed for use in tiny infants, but not lactating mothers. The amount of flucon that reaches infants through breastmilk is much smaller than that licensed to be given direct to infants, so is therefore deemed to be relatively safe despite the lack of research.

[LackaDAISYcal]

pobletsmum, it's apparently to do with it being a choking risk . The BFC who did my peer supporter training was very sceptical about it.

[hedgehog1979]

So sorry to hear about your problems. My DS is a couple of weeks younger than yours and after having really bad nipple pain I finally saw the GP today and was pescribed fluconazole for me and nothing for him as she was not sure that he has it and the amount that transfers through breastmilk would help to treat him if he does have it.

I would go back to your GP/ask to see a different one and refuse to move until they help you (I always find tears helpful) am not being flippant but sometimes they seem more human after dealing with a weepy postpartum mother!

[pobletsmum]

Funny you should say that LDC as I eventually stopped using it for exactly that reason. Have you ever used it/seen it used? No mean feat, however carefully you do it. Blasted stuff does work though. It swims around in baby's mouth like a lump of toothpaste. You're supposed to spread it on all the surfaces inside the mouth but it's soooooo slippery. You are supposed to use 5ml, which is a HUGE amount for a tiny baby. To see your baby stop breathing is terrifying, however it happens (I was already quite used to it due to oversupply regularly choking DD!). I am not at all surprised about the 4month suggestion.

Thrush is evil!

[pobletsmum]

hedgehog - I didn't think fluconazole through breastmilk alone was enough to treat thrush in an infant. BfN say it's essential to still use topical treatment for you and baby to avoid re-infectng each other.

[LackaDAISYcal]

I never used it for DD, just nystatin drops for her, and daktarin on my nipples.

It took me six months to get rid completely though

I also used Australian bushflower green essence as recommended by a firend which helped in the end to clear it up. I think it's similar to the grapefruit seed extract in the way it works. Add to that I was taking acidopholus tablets on princessofpowers' recommendations , so a combination of everything finally worked.

[Lib76]

thanks so much guys for advice. i have been using mepilet dressing on cracked nipples (similar to jelonet) which has helped. spoke to BF counsellor over weekend and she was very helpful, i was getting him latched all wrong and now at least have got that right!

Good new on the fluclonazole front! my HV phoned me this morning and she spoke to my gp and she has now prescribed it! horray! things can only improve!

[pobletsmum]

Great news!

[ILikeToMoveItMoveIt]

Lib76 - moist healing is the best way for your nipples to heal (even though it goes against everythig you know about healing.) Slap on the lansinoh and make sure your nips don't dry out - they will heal, and you will start to notice the difference in a couple of days.

If you let cracked nips dry out the danger is they crack even more.

Good luck xx

[Lib76]

thanks for advice on healing. the dressing i have got keeps them moist which does indeed help the cracking. is much more painful when they are dry and DS goes on! hopefully things will sort out soon!

[hedgehog1979]

pobletsmum GP and HV could see no evidence of thrush in DS and the thrush I have is a 'deep' thrush if that makes sense

[MrsAlwaysRight]

Fluconazole is fab! It started to ease the pain I was in fairly quickly. You have my sympathy as it is sooooo painful.

[MrsAlwaysRight]

Lib76 - How are you getting on - any improvement?

[Lib76]

Hi! MrsAlwaysRight!

was getting ok in terms of thrush but yesterday was feeding DS with no problems (or so i thought!) and when he came off there was blood everywhere! so thought i wouls rest that side and just feed from the other, then low and behold the other one was bleeding too! totally gutted. had to give him formula overnight. he was none the wiser and thankfully been very settled (unlike me!) bought nipple protectors today and have managed two feeds with them. they seem to work, but it's very odd using them! i will keep on going as long as i can. but don't want DS drinking blood again!

[Yankunian]

I wrote am almost identical message about six weeks ago, when my dd was six weeks and we both had thrush and I was so fed up I considered stopping bf. But now the thrush cleared up and BF is a breeze. My GP wouldn't prescribe flucon either so I bought two 150 mg pills OTC and took them 2 weeks apart while getting on with the nipple cream, and the nappy cream and oral suspension for babs they gave us. Also cut out sugar/bread for a while - all seemed to work fine and it cleared after a week or two.

The main problem, worse than the thrush for us I suspect, was the latching problems we had simultaneously tho I didn't realise at time - dd wasn't really opening wide enough at the start, and didn't get a good latch so would twist the nipple and writhe around, while my nips were throbbing. Going to a bf clinic helped tremendously - she got it after a bit of retraining, and I learned not to put up with it! Applying lansinoh and wearing those plastic nipple shells after a tough feed really helped them heal, too - keeps them moist and they can't stick to anything and dry out.

Good luck with this - I found it incredibly difficult to get through, but it really did get so much better so quickly. I never believed all those people who told me BF would actually be easy for me in a month or so but they were right!

[MrsAlwaysRight]

Hope things have improved since your last post Lib76