Thrush - given Daktarin ORAL gel for nipples & how to stop it coming back

[JamieJay]

Went to GP this morning as have had awful nipple / breast pain after feeding since Friday and DD has nappy rash and some white in her mouth.

Have been given oral drops and cream for DD, GP then spoke to their in-house pharmacist who recommended I have the oral gel for my nipples so I wouldn't have to wash it off before feeding DD.

Has anyone else had this approach from their GP? Slightly concerned that oral gel should only be used in the mouth.

Also, what should I be doing to stop the thrush coming back - am washing all bedding, blankets, bras etc. with vinegar, should I be doing anything else??

Thanks

Which drops have you been given for DD? If nystatin then go back and ask for daktarin gel - nystatin really really doesn't work.

If you are getting deep tissue pain after feeding you are likely to need a course of fluconazole to clear the thrush (as well as the oral gel for DD and cream for your nipples) which you will really really have to push the GP for. Useful to get HV on side if possible.

I speak from bitter experience - took me weeks and weeks of pain, useless creams/gels, trips to variety of GPs before I finally paid for a private lactation consultant who wrote a letter to my GP saying I needed fluconazole. I was on fluconazole for a week (you need a big first dose and then a tablet every day until the pain has stopped after feeds for a week IIRC) and the pain started to get better.

See here for useful leaflet on treatment of thrush.

Good luck - really hope you get it sorted x

Sorry, didn't answer your question! Daktarin oral gel for DS and daktarin cream for nipples is what I used. I didn't wash the cream off before feeding (GP said that was fine).

I used cream on the nipples, but using the gel sounds like a good approach. Agree with Bicnod, fluconazole really works. I am on a course now and feel better already one day after the big starting dose.
I wish I knew what would stop it coming back as this is my second time with agonising thrush. I thought taking probiotics would help - maybe it's worth a try?

Thanks Bicnod. Will give it a couple of days and then head back - at least then I can say I've given the gel and drops time to work.

It is nystatin I've been given for DD but I have the Daktarin gel rather than the cream.

Rene - I found this in an old mumsnet thread:

Drinking Yakult each morning
Taking acidophillus tablets AM and PM
Rinsing nipples in vinegar after each feed
Using daktarin cream after each feed
Daktarin gel on baby after each feed

Soaking bras, muslins, towels etc in vinegar solution and washing separately at 60C
Changing breast pads at every feed

Am going to try all of them!

I was given the oral gel for my nipples and it did nothing - t he gel isn't designed to be absorbed through the skin. Went back and saw a different HV and was given canestan cream for my nipples, oral gel for ds. I didn't have breast pain though, just itchy nipples.

The Breastfeeding Network do a good leaflet on thrush - look on their website. It's good to take to your GP.

gel might stop you getting it but don't think it's going to work if you've got thrush already - you can buy over the counter one of those thrush tablets you take if you have thrush down below if your gp won't prescribe anything. I wouldn't mess around and leave it a few days tbh - ouch!

Really don't bother with the nystatin drops for DD - use the oral daktarin gel you've been given for her and go back and ask for daktarin cream for your nipples.

Grapefruit seed extract is supposed to help as well - I added a capful of the liquid to every wash and took the tablets every day.

But really - it's all about the fluconazole - if you've got the deep breast pain after feeding that's the ONLY thing that's going to shift it so get an emergency appointment with your GP, take the BF network leaflet (linked above) with you and don't leave the surgery until they have prescribed you at least a week's course of fluconazole, including an extra for the initial big dose you need. GPs don't usually know much about breast/nipple thrush and are reluctant to prescribe fluconazole but they CAN do it - you have to push them.

Thanks all - I don't think I'm getting deep breast pain just around my nipples. To be honest I don't think it's helped by the fact DD's latch has got a little poor over the last few days because her mouth is probably sore.

Will go back to the GP and push for fluconazole.....

Fluconazole is essential - you need a loading dose AND a longer course (I had three courses of 7 days!). As already mentioned here the oral gel will not go into the skin and is pointless on your nipples. Daktarin cream should be used on your nips and doesn't actually need washing off - just use a small amount and make sure there's no residue. Even then the cream doesn't enter the milk ducts.

My experience is that GPs know little about this. I recommend printing the leaflet linked to above, read it carefully so you know the details and take it to the doctor to show them.

Incidentally fluconazole isn't licensed for BFing mums, however, the amount which comes through the milk has been shown to be significantly LESS than the amount which is licensed to be given to infants - this is important if the GP objects.

Second the Fluconazole. I had bad thrush whilst BF ds and this sorted it out. I took a print out of some info from Kellymom and thankfully had a GP whose wife, also a Gp knew everything about BF and gave it without question.

Thanks, will demand fluconazole - bursting into tears won't be difficult so will bring that to the table if necessary.....

Good luck, let us know how you get on .

Glad to hear you recommend fluconazole. I'm based in Ireland & the lactation midw in hosp where I gave birth assessed me and said I need 28 day course of 150 mg. Took my bf group leader 2 phone calls to my doc to prescribe it. I've been tryin daktarin, nystatin & they're doing nothing. Mine is deeprooted with no signs externally or in dd mouth or on bum. It's bloody painful isn't it?! HAve had it 6 weeks now and have been so close to giving up bfing so many times. My mantra was 'One feed at a time'
good luck to all fellow sufferers

Very, VERY painful. Very.

But, I promise it can be fixed and it's wondeful when you can feed without pain again.

Agree with others. Ask for fluconazole. I had to take several individual tablets ( the same for vaginal thrush) then a seven day course to finally shift it. The doctor had to check in a little book whether it was suitable for bf women, and it is, but they haven't done extensive studies, so some doctors don't seem to know that it is. Be persistent if they don't prescribe it. Apparently only traces will go into your milk, but if anything it will help your dd get rid of it too. Good luck.

Hi, sorry to crash thread. I'm not sure if I have thrush, am on 2nd week of antibiotics for mastitis in left boob. Before mastitis I had awful cracked nipples which are better and The mastitis seems to be getting better but nipple pain in left boob is back and excrutiating when feeding and for an hour or so after. My nipples quite often go white and the left is painful to touch all the time. I also have burning pain in breast- 2 sorts- one in both when baby cries and milk comes in and the other in tissue under nipple of left boob.
so exhausted now wondering how on earth I can get round to soaking and rewashing everything that's been in contact with nipples :( and as I was reading I was tucking into giant bag of haribo :( oh i just can't go on like this much longer feeling so low

oh and it's really just left boob, can you get thrush just in one side?

How essential is the big first dose? I've just been prescribed a 10 vday course of Fkuconazole, but no big dose. Ds was not given anything - Midwife has insisted I get intouch with dr tomorrow and push for him to be treated. Should I ask about the big dose as well?

And should I have cream as well? Thank you and sorry for the thread hi-jack

sorry about typos - ds feeding as I wrote