Ouch, thrush. Ouch ouch ouch!

[Readytoburst]

HELP! I have a dd with a Tongue tie and thought this was the reason I'm in agony. Noticed yesterday that dd has really bad oral thrush which she has kindly passed on. She's on daily antibiotics and will be for the foreseeable future so likely that it will return even if treated. I'm seeing a lactation consultant tomorrow and I'm hoping she'll be able to sort some treatment. If not I won't be able to see the dr til Tuesday. I've given up with nipple shields as she doesn't feed properly and am expressing and using bottles. Does anyone know of anything that might help in the meantime? With my last dd I know that diluted vinegar solution helped on my nipples. I really don't want to give up as dd has a dodgy kidney and I know breast is best for it but I'm in soooooooo much pain (even when not feeding) I don't know how much I can take!

Totally sympathise and you will get loads of advice on here, but in the meantime:

• probiotics for you and baby. She will get them from you I believe, but you can also give them to her in powder format, straight into her mouth

• Breastfeeding network has leaflet on treatment of thrush with fluconazole and topical creams; my gp found this leaflet so helpful, he kept it

• Gentian violet, see the jack newham website

• diluted vinegar solution for nipples after each feed

• change breast pads after each feed and bras regularly

• boil wash anything in contact with milk/mouths, etc

• cut back on sugar (can't say I managed to do this)

Good luck, I know how awful it is.

You can get a one-off dose of fluconazole otc - it needs to be followed by 10-14 days of the lower dose but could start you off tomorrow if you then see the GP on Tuesday.

1 T white vingar in 1 cup water is the volumes. I found this really helpful for bathing nipples after every feed/pump.

Probiotics and better hygiene (always change breast pads after every feed, etc) can make a big difference.

Have to disagree with camper, sorry, but gentian violet is no longer recommended as it's mildly carcenogenic. It's pretty tough to get hold of, too, and if you're going to the docs on Tuesday you can get just what you need then which is prob quicker than you could get anything like GV online.

Your pharmacy should be able to sell you Daktarin GEL for your baby, and CREAM for you. This is Miconazole if you get a generic version. The gel needs to be carefully wiped around the mouth in little smears - not big bits to avoid chocking. The gel is sticky and stays in the mouth to do its job but doesn't sink through skin so isn't suitable for you, whereas the cream is skin permeable.

I would avoid vinegar as it will dry the nipples and may cause cracking.

Is the pain inside your breast? If it's in your milk ducts you need a specific dose of oral Fluconazole as the cream won't fix that. The over the counter tablet for vaginal thrush is not strong enough and then you need a lower dose for quite a while afterwards.

On an ongoing basis you will likely be fighting this, as you say, if she's on long term antibiotics. So firstly, clear this one up if you can by continuing to treat until a week or so after symptoms have stopped. Thereafter there are a number of things to do:

1. Make sure that you keep everything absolutely sterilised (dummies, nipple shields, teethers etc). Change dummies several times a day.

2. Iron the inside of your bra and wash after every use to keep on top of any spores.

3. Boil wash towels after use (you can use a facecloth to dry your nipples to minimise washing volume).

4. Splitting an acidophilus tablet, wetting your pinkie and dipping it in the powder, and letting your baby suck it off is an easy way to get some good probiotics into her. I would take the full dose of these yourself on an ongoing basis. When she's weaning you can mix the powder in with yoghurt, or any other puree type food.

5. Grapefruit seed extract is really helpful (NOT grape seed oil). You can get it in tablets which you take every day and they help clear systemic thrush (good to take with the fluconazle if you have ductal thrush). You can also get a liquid version (you need the type with citricidal in it). This type is useful for loads of things. A couple of drops in the fabric softener drawer of your washing machine will keep on top of the spores for you. You can mix it with water and drink it (although it tastes horrible so I prefer the tablets) and you can mix it with water and put it onto your nips or wipe your baby's mouth with it (but it's drying and tastes bad so Daktarin may be preferable).

The leaflet you need, though, is this one:

www.breastfeedingnetwork.org.uk/pdfs/BfN_Thrush_leaflet_Feb_2009.pdf

BTW this is really contagious so don't share towels with your partner, and take care when drying yourself to use a separate towel for your breasts and your genitals, otherwise you can end up infecting yourself down below, too. Again, this is where a facecloth is useful for your boobs!

Watch our for nappy rash in your DD. Persistent nappy rash may be the thrush infection and you will need Canestan for this.

Thank you all. Dd is only 12 days old so didn't think they'd give me the gel over the counter. I've used it before when dd1 had thrush. Wasn't nearly as bad as poor dd2! On the up side, she's taking bottles of expressed milk beautifully!

ready it's possible they won't. If possible, it's worth going in without your DD (or sending someone else in) and not telling them her age.

Are you getting a referral for getting the TT snipped?

Are you planning to EExBF? Do you want to go back to BFing when the TT is snipped?

Canesten oral is 150mg which is within the range recommended by the BfN leaflet fwiw.

Organic - my midwife came to discharge me Friday and when I raised concern over the tt, she said I needed to see lac consultant. It was only after this I noticed the thrush. Dd is facing testing and possible surgery for kidney so i think if I can avoid snipping I will - dont want to put her through more. I'm not sure what lac consultant can do tomorrow as I'm in so much pain I don't think I can bring myself to let her latch on but I have to go so midwife can discharge me.

I do want to go back to bf but expressing some so my husband can feed and we can go out sometimes!

Yes, that is true, so either one or two tablets could be taken as a loading dose - but it's very expensive and if, OP, you are able to get to the GP on Tuesday, it's maybe worth waiting. Your choice but the information is there for you. You must get the ongoing course, though. One dose isn't enough.

Daktarin is also on prescription so you can get the gel and cream free for you both.

That's assuming the GP is supportive. Taking the BFing network leaflet I linked to may well help, and if there's a query on the Fluconazole not being licensed for BFing women, point out that Fluc IS licensed for babies in higher doses than it appears in BM.

Thrush is absolute hell. But it gets better really quickly when properly treated.

X post.

Ready, at her age the TT snip will be nothing, but if you leave it it will be harder to snip, and eventually she'll need an operation to fix it.

I would highly recommend speaking to your LC about which consultant she would recommend you getting yourself referred to, then ask her to write a note to your GP asking for them to do just that. You can get the advice from the TT snipper (I think they're usually ENT consultants) and you don't actually have to do it, but I would have all the info you need as feeding with a TT will continue to be V painful (although may get better as she gets bigger).

At her age the TT snip is a little snip with scissors - literally - and it's very, very minor. You will probably need LC support to get the latch just right afterwards but then you can BF her through any kidney surgery she has, which would be so nice for her to have that lovely support.

When you say LC, is she an IBCLC?

"little snip with scissors" sounds awful, I know :( but honestly, from everything I've heard the babies just hardly notice it.

Unfortunately my DS is nearly 8 months and to get his done would be a much bigger deal, not he's so big, but it wasn't diagnosed until about 6 weeks ago (when I finally found out why BFing was still hurting :( )

not now

I have no idea! She's the lactation consultant at the hospital!

OK.

It's worth asking. Some LC at hospitals have been on a one day course.

Some are very, very highly qualified.

LC "should" mean IBCLC which is a very good qualification but may just be the job name she's been given.

See how you get on tomorrow then, and let us know :). Good luck.

Thank you - I will!

Update! Lac cons has referred for tt assessment. She have helped with a better latch but couldn't sort treatment for thrush. She did write a note for my dr recommending what to prescribe. He has prescribed nystatin and some cream for dd's bottom and some cream for me. He wouldn't prescribe the oral medication! I'll be going back for it in a few days if things don't improve!