Thrush...thrush...and more thrush. Help!

[Annie456]

Evening all,
DS1 is now 4 weeks and BF is still a pretty unpleasant event. We've sorted his Tongue tie but I have thrush (presumably as a result of some huge cracks caused by the TT that now won't heal because of the thrush.

First round of fluconazole hasnt worked (was on 50mg twice per day) so now GP has prescribed 200mg once per day for a week...I'm worried that it's not a twice a day prescription and it's wasting another week. Did anyone else have this dose? I've also been given an antibiotic (flux something?) as I have a suspected secondary bacterial infection.

Really don't want to waste another week and want to trust my doctor but I thought I needed to take it twIce a day for a couple of weeks...
Xx

Annie poor you! Hope someone comes along soon with either the experience or the training you need .

I had Thrush constantly until my daughter was about 5 months (5 times in total) - the last time it came with excema all over my breasts/nippes and took ages to shift (6 weeks). Feeding my DD every hour or so was pretty grim and I felt so depressed about it and couldn't wear a bra for a while. I came very close to giving up a few times, but my DH spurred me on and reminded me how I had said I always wanted to BF as long as I could.

I paid to see a private lactation consultant at the fifth time and she helped me with some alternative remedies, suggestions about a low yeast diet to combat the Thrush and gave me a very good LLL leaflet (you can buy it from their website here) www.lllgbbooks.co.uk/product/264/treating_thrush_-_pack_of_20_folded_a3_sheets/default.aspx.

I hit is with everything the leaflet suggested and a 3 week solid course of Fluconazole (50mg per day instead of the loading dose of 3 x 150g which is often prescribed and which I had 4 times along with Daktarin gel for my DD) . I also used Diprobase cream on the breasts (not harmful to babies unlike the Daktarin cream which had to wiped off before feeding and was such a faff). This shifted it i the end. I bathed in Aveeno oil in the bath too. I also went regularly to our local Baby Cafe and got a lot of support there. My GP wasn't much use - I had to take the suggestions from the Lactation Consultant/baby cafe to her (they don't know much about persistent Thrush and the first wouldn't even prescribe Fluconazole due this business about it not being licensed over here for babies)! If you don't/can't want to wait for the leaflet I can write down in more detail what I did (just got to nip out) - let me know - happy to help. I am with you - it's awful, but it is curable.

Annie are you getting some RL bfing support too, either from a BFC or a Lactation Consultant?

Yes I am seeing an infant feeding specialist at kings. Also going to a BF cafe and other post natal groups. I know that pain free BF is possible, I just don't want to waste more weeks taking the wrong dose etc.

Yes, it would be great to get more info about how you finally got rid of it. I've started religiously washing my hands and washing bras Muslins and towels at 60 degrees. I'm taking a pro-biotic that cost me a small fortune from one of those boutique alternative therapy places and trying to cut out sugar and yeasty things (though that is really hard when I'm so tired) anything else is worth a try too.
Thanks!

Glad you are getting some RL support, hope you manage to get rid of the problem soon

Hi this is probably suggested in the leaflet but other tips for dealing with thrush include making sure you change breastpads at every feed and avoiding soaps that are anti-bacterial as these can kill the natural bacteria that keep thrush at bay. I'm sure this has helped me. Another tip is to iron your bras with a hot iron as this can kill lingering yeast.

Good luck getting rid it really is miserable.

Here's the definitive guide to thrush treatment:

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

What westyorkshiregirl says about Daktarin isn't TOTALLY accurate. (sorry :) )

Daktarin cream IS safe for your baby, and if you are using so much that you need to wipe it off before feeds, you're using too much. If you apply it directly after feeds, not leaving any residue, you're fine. It's not suitable for their mouth - Daktarin gel is the version for baby. Topical treatment for you both alongside oral treatment (Fluconazole) should give the fastest results (treating baby as well as you will stop you transferring it between yourselves). Diprobase is for the excema she suffered, not the thrush.

I used to dry my breasts after a shower with a facecloth, then hot washed it (60 degrees). Saved washing a whole towel every day!

The antibiotics may make the thrush worse so you may need to treat a little longer for the thrush.

I've personally been through exactly the same thing - raging ductal thrush, severe tongue tie, blocked ducts, terrible nipple damage etc etc and I'm still BFing at 15 months (and planning to term feed) so it can be done :)

Thanks carrotcake I do believe it can be done. Im doing everything per the breastfeeding network guide and I have spoken to my GP who is adamant that I have the correct dose so we'll see. I'm using the daktarin too but not after every feed so will do that.
Thanks again..fingers crossed.

Have hunted out all my info - here goes:

• Wash everything that comes into contact with breasts and baby dribble at at least 50 degrees (I washed everything at this)
• Changed my bra every day (and only wore cotton ones)
• Stopped wearing breast pads entirely and ensured breasts/nipples stayed as dry as possible
• Used Diprobase emollient cream (over the counter from chemist)
• Bathed in Aveeno oil to soothe the skin - my biggest problem was extreme itching with the excema/redness and this helped
• Hand washing for me and baby
• Separate towels from rest of family
• New toothbrush and to be kept separate from DH's
• Stopped expressing milk entirely and never re-started, threw away stored milk
• Limited sugar and other refined carbohydrates as much as possible (but I too craved sweet things so had them if I really fancied them)
• Tried to see if any foods made it worse (e.g. yeasty things) but didn't see a pattern
• Tried Canesten and Daktarin cream for me, but neither very effective
• Tried Nystatin for DD, but Daktarin gel worked better - used to put it on my finger and let her suck it for a while.

• Nutritional supplements I tried (from the LLL leaflet):

  *Probiotic tablet (Lactobacillus acidophilus) according to packet  instructions (mine were 3 x per day) and for 2 weeks after symptoms have cleared. Got from Boots. Also a daily small carton of Actimel and lots of natural yoghurt.
 * Grapefruit seed extract (Citricidal) via Higher Nature website - warning - tastes FOUL even in juice, 5-15 drops in 150ml water 2-5 times per day.
 * Zinc acetate or zinc gluconate - 45 mg daily via Higher Nature website (I got tablets).
 * B Vitamins - 100mg daily of each ( I took a B vitamin complex with them all in) from Boots.

Higher Nature are really good and have advisers you can talk to. I also got vaginal thrush the last time and bought a probiotic suppository from them which helped.
I had a few problems if I mentioned I was b/f as some of these were on their lists of things you shouldn't take (even though there is research they work!)

Things I didn't do but were suggested:

• Throw away old make up
• Use sterilising fluid to clean toys and dummies (she was so little at this point, she didn't really put anything in her mouth and she didn't use a dummy)
• Consultant also recommended DH be given Fluconazole as he could have it too and might have passed it back on his hands etc, but we didn't get to this point.
• Using Gentian Violet, but I couldn't seem to find it in the UK (A MNetter later told me she got some via Ebsy) www.breastfeedinginc.ca/content.php?pagename=doc-UGV

I did have the loading dose of 3 x 150mg of Fluconazole four times over several months and it worked, it was just the last outbreak with the excema that was resistant which is where trying different combinations of Fluconazole came in (50mg p/day over 3 weeks). It might be worth giving the lower dose a try as I think the symptoms are very slow to clear and sometimes it gets worse before it gets better. It might be a case of trying a few things before they work.

I hope this helps.

It's taken me several attempts to add this info and I see that others have posted in between!
Organiccarrotcake I was told strongly by my GP and NHS Lactation Consultant that Daktarin cream had to be used sparingly and wiped off before feeding (although at 2,3 and 4am I pretty much forgot to do that and my DD is fine - I was just repeating what I had been told and if you know different, then great. I think I've made it clear in my last post that Diprobase was for the excema and that I used Daktarin gel for the baby. Personally I didn't have much luck with the creams, but that's just personal experience.

Oh and when ironing bras, be careful to avoid the pretty/ribbon bits than might melt and stick to your iron and ironing board........

LOL @ ironing bras . Yes, it's really important to do it but poor WYG :)

OP, what WYG put on her list is stuff I should have mentioned . Grapefruit Seed Extract can be really good. You can take it orally and it's also possible to make a solution of it for topical application BUT this can REALLY dry your skin so I don't recommend it! Orally as tablets or (yuck) the liquid in water is very helpful. You can put the liquid in your wash, too 2-3 drops in the rinse cycle (where the softener goes) will help to kill off the spores in your washing. If you use cloth nappies it helps to sterilise them, too!

Also acidophilus. Definately a really helpful one.

Gentian violet used to be recommended as it's very effective, but is now not available in the UK because, by memory, it's thought to have carcenogenic effects.

WYG regarding the Daktarin cream, what I was trying to say is that if it's applied after feeds and gently rubbed in, with no residue, it's fine not to clean off before the next feed. I wouldn't want a baby sucking on blobs of it which is why they say to wipe it off, meaning if you'd just put a load on and you can still see it :)

Canestan isn't really suitable for nipple treatment. It can trigger eczema and Daktarin is better when babies are going to get teeny bits from the suckling.

Nysatin doesn't work so well as Daktarin oral gel (for baby's mouth) because it's a liquid, and just flows away (unlike Daktarin which is a gel that sticks around long enough to have some effectiveness). Also it's full of sugar which thrush thrives on!!

Is your baby being treated as well as you?