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Infant feeding

Get advice and support with infant feeding from other users here.

thrush in nipples - advice please

4 replies

cep · 18/12/2011 18:39

My 5 wk ds was diagnosed by hv with thrush (on bottom not mouth), at the same time i discussed with her pains i had been having in my breasts. Hv thought i also had thrush so i called the gp for telephone advice, she prescribed Daktarin oral gel as ds could then still breastfeed. Has anyone heard of this being used as an external nipple thrush treatment? My nipples had become very sore and is agonising when ds first starts feeding, i have only used the gel a few times so haven't as of yet had an effect. Could anyone advise whether this could be successful.

Thanks

OP posts:
marylou242 · 18/12/2011 20:51

I've just had thrush along with my 5 week old. We had trouble getting decent medication (think the NHS was being cheap as usual). To start with we had nystatin drops for baby and cream for me. This did nothing. I went back and got daktarin oral gel for baby and daktarin cream for me (although I think you can also use the gel on your nipples). I also had a fluconazole single dose capsule. However the thrush still didn't go so I went back to the doctors again and was prescribed a longer course of fluconazole. The thrush has now gone although we've still got problems which I think are due to a tongue tie. I suggest you perhaps go back to the doctors because if the thrush is in your milk ducts, you need to get something that gets inside your body and fights it from inside. The cream won't get into your milk ducts to treat it in there. It did take a good week to clear up when we were using the long course of fluconazole, and both daktarin treatments. My health visitor advised taking yakult to stop the anti-fungals from killing off everything in your system. Good luck, I know how painful it is!

stegasaurus · 19/12/2011 13:35

I also needed a 2 week course of fluconazole. DD's oral thrush cleared up with nystatin but the clotrimazole cream didn't help me. She didn't get reinfected, but I was in so much pain that I almost gave up feeding her before the HV at breastfeeding group suggested thrush. I was given a leaflet to take to my GP advising what to prescribe. I have also seen other posters link to it here but can't remember now which organisation produced it.

organiccarrotcake · 19/12/2011 22:46

There's a lot of confusion amongst GPs over the use of thrush meds, mostly because many of them aren't licensed for lactation (although they're so widely used that they're shown to be safe).

Nystatin drops are often given to the baby, but it's in a sugar solution which can feed the thrush and make it worse (thrush thrives on sugar).

Daktarin GEL is for the baby's mouth and is not suitable for nipples as the carrier gel doesn't sink into the skin properly. Daktarin cream is the same drug (miconazole) but in a cream based carrier which will sink into the skin. Daktarin gel is sometimes not given to young babies (under 4 months) because it's really thick and is considered to be a choking hazard. However, a tiny smear on the finger rubbed over the gums and tongue is fine if done carefully (a new smear for each mouth section).

Clotromizole (Canestan) is sometimes given to mum but it can trigger skin reactions. Daktarin (miconazole) is less likely to.

Fluconazole is used to treat vaginal thrush in low-ish dose, one-off treatment. It can be used to treat thrush within the milk ducts but a higher and longer-term dose is needed. It's not required if the thrush is on the skin only, but is generally needed when it's in the milk ducts. It's not licensed for lactating women because there are no safety studies done by the licensee (you can't do studies on lactating women!). However, the amount of the drug that passes to milk has been studied and is less than is licensed for babies - so is considered to be safe to use while breastfeeding. But if the GP or pharmacist just looks at the drugs list they won't see this.

This is a really useful leaflet: www.breastfeedingnetwork.org.uk/pdfs/BfN_Thrush_leaflet_Feb_2009.pdf

Finally, watch out for hygiene as thrush is highly contageous. Be really, really careful about hand washing after nappy changes and wash anything that touches the affected skin on a 60 degree wash or hotter. Looking into grapefruit seed extract as a complimentary treatment is worthwhile.

MummyAbroad · 20/12/2011 14:28

lots more really useful information here

www.kellymom.com/bf/concerns/thrush/thrush-resources.html

The Daktarin oral gel will be very drying for your nipples which wont help soreness, you might want to consider using it just before a feed - because it gets in baby's mouth at the same time, and use something else for after a feed (other creams generally have to be washed off nipples before a feed, but the oral gel doesnt)

Some home remedies will help, but you really need to attack this with everything, prescription meds + complimentary stuff. Try a rinsing nipples with vinegar and water regularly (the acidity prevents regrowth of bacteria) and/or baking soda and water. Also try taking high doses of acidophillus capsules (good bacteria) Dont use lasinoh and be aware that any cream will keep the area moist and help bacteria growth, you should aim to keep nipples as dry as possible.

Talcom powder on baby's bum will help keep the area really dry, but be very careful that baby doesnt inhale any.

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