Taking fluconazole, Expressed milk question?

[Snakeonaplane]

I am on day 3 of a course of fluconazole, I gave thrown out all milk from before I started taking the meds and haven't expressed for 2 days but have started again today mainly for comfort and to encourage milk supply in the evening, baby sleeps a lot and only has small feeds but from experience she'll have a growth spurt soon and won't be satisfied. So my question is do I need to dump the milk from now or can I keep it?

no you can keep it, fluconazade is perfectly safe to take when breastfeeding why were you dumping anyway?

I thought that fluconazole was a no-no during pregnancy and bf so am quite suprised you were prescibed this. The presciber should have told you what to do ie when you could start again etc. I would contact presciber before doing anything. Hope it worked tho'. . . .

I took fluconazole during bfing and continued to bf as normal.

Sorry you have misunderstood me. I'm feeding as normal but wondering if expressed milk is contaminated with thrush. Was advised to get rid of the milk I had expresses whilst I had the thrush.

Fluconazole is what the breastfeeding network and infant feeding advisors at the hospital recommend for ductal thrush, not a no no. They give it to preemies in higher doses than ends up in your milk.

sorry meant to say, although it isn't licensed for use in breastfeeding (hardly any drugs are) it is generally regarded as safe as the amount that passes through to the baby is a lot less than the dose a baby can safely be prescribed the world health organization recognises this drug as safe for to take with breastfeeding.

I am not sure what the correct answer is (if the milk is contaminated with thrush) but can offer my experience:

I got painful thrush in the milk ducts after having cracked bleeding nipples and the course of fluconozole cleared it up (stopped pain deep in breasts) my nipples also healed but continued to feel a bit sore and were red for a long time until i eventually found the right cream which cleared it up. Managed to clear thrush of babies bum too (this all took weeks) but to this day he still has it in his mouth (he is 2 and half months old now, we got thrush in the first week!)

However, I am not in pain, and he doesnt seem at all bothered by the small amount of white on his tounge, so I stopped giving him the oral gel. I am confident that now that the latch is good and I dont have cracked nipples I wont get re-infected in the milk ducts, and my nipples arent even sore anymore (perhaps because I am able to keep them dryer now, less feeds,and no more lasinoh? whatever the reason, the thrush from his mouth doesnt seem to be growing on my nipples anymore)

Anyway, (sorry this is getting long) my point is we havent completely eliminated the thrush, but no one is suffering anymore, so I am no so bothered about the re-contamination thing. If you have cracked nipples I definitely would try to totally eliminate the thrush and wouldnt take chances with the expressed milk, because otherwise it will go right back into the ducts, however if you are healed, perhaps its not so necessary.

not sure if that helps at all, but you have my sympathies too - hope it clears up soon!

Thanks Mummyabroad it does help, dd is 4 weeks and has been having oral gel for 2 weeks, it doesn't seem to bother her but it isn't clearing up yet.

I exclusively expressed for ds. when I had thrash I asked if id have to dump my expressed stash. gp and feeding advisor both said no it was fine to keep giving him it. I got fluconazole too!

Snakeonaplane - what lead the Dr to the thrush diagnosis? Has other things like Tongue tie, Raynauds' Phenomenon/vasospasm, shallow latch been ruled out?

I'm not, in anyway, doubting that you are in pain I'm just concerned that 2 weeks of treatment in baby hasn't made any difference and you are now on fluc. Has the pain got any better on the fluc.?

DD and I had Thrush five times in 5 months and loads of Fluconazole. I kept on feeding, but didn't keep or express milk at all for fear of re-contamination. I did wonder if the pumping might have led to some of the thrush as I got a slight sore sore spot from the funnel and that then became itchy and inflamed and it took weeks to shift. The Lac consultant I saw said to make sure the pump was thoroughly sterilised and cleaned. Good luck.

Sorry, I'm doing a terrible job of explaining this foggy new baby head and one handed typing . It's the thrush in the babies mouth that isn't clearing. My thrush feels 100% better I'm day 3 of the treatment and have no pain anymore. I've had thrush with my last 2 babies that never got treated properly so this time did a lot of research re thrush, GP was very reluctant to give me the fluconazole despite bringing the bf network leaflet all he would give was canestan and daktarin but went back and saw a different GP who took advice from the hospital and prescribed it. It seems to be working but I don't think the daktarin is working that well on the baby but other than it being visible it doesn't seem to be bothering her whereas ds used to struggle to feed keep pulling off and I ended up with mastitis about 5 times.

fluconazole is one of the drugs that can be used during pregnancy and b'feeding but like many drugs cannot be safely trialed as the target audience would in turn be putting babies at risk if it didnt work and ethically this cannot done. However it is a drug that comes under the "has been used many times with no adverse effects reported to mum or bub" area. Should be prescibed by the gp or o and g drs.

OK that's great that it's working for you - was worried it wasn't doing anything and you were just having to plug away with the pain.

Thanks West, I've been paranoid about the pump I've been boiling it and then putting it in the steriliser as I'm sure expressing contributed last time.

Dd is piling on weight but having very short 10 min feeds, she is sleeping really well but I'm paranoid my supply is dropping as she sleeps a lot and the last time my boobs used to get really full before feeds but now they never really feel full and I hardly leak. I try to encourage her to feed more but she keeps falling asleep so I've been expressing but hate throwing out the milk as I don't find it easy and I'm sure I'll need it.

Sounds normal Snake, quick feeder, efficient supply (the 'full' feeling is extra milk - why make extra when your body knows what your baby needs?), leaking tends to get progressively better with each child too.

HTH

Oh that's really good to know re supply with each child. I was worried that she'll decide she needs a lot more milk next week and supply will have dropped off because she is so sleepy.

If she does it really won't take long to get more milk. If she goes through a fussy period you can try switch nursing (feeding baby on 1st side until they slow down then switching to 2nd until they slow, then switching back and so on) as that usually gets supply up quickly. Not something to worry about now though!

Just to check (CMA time) she is doing plenty of wet nappies (with clear/pale not dark wee), weight gain good and feeding about 8-12 times a day?

Her nappies are so wet they are like a toddler that gets forgotten about they are actually heavy, she isn't a pooer though, sometimes once a day, sometimes every 2 days but they are good bf baby nappies when she goes. I think she's put on at least 2lb in last 2 weeks she's a bit of a chunker but was a very low birth weight for my babies others were 9lber she was 7lb 9 and lost at first but I reckon she is close to 10 now.she is sleeping from 10 pm to 5pm and has at least 8 feeds a day and is very, very content, no fussing but offered feeds a lot (basically any fuss). I have time as my others are at school, which is a luxury I didn't have with the others as there at not a big age gap between them.

No worries about milk intake then! I just suddenly had a little niggle when you said she was very sleepy but if she is weeing for England and chunking up at the rate of a 1lb a week then she is taking in enough milk

I think she is probably just newborn sleepy but you forget how much they sleep don't you? She wakes for feeds and then she's straight back to sleep today but then I was u out at 8.30 this am which probably was a shock to her little system being turfed out of bed at that time.