New Breastfeeding Network Thrush FAQ leaflet: why the changes?

[OhBuggerandArse]

Both the new leaflet and the old one (which I thought was very useful) are available here.

The recent guidance has some stuff in which I think is odd, and which might discourage people with genuine infections from seeking treatment - most notably for me the idea that a thrush infection will always be felt equally in both breasts, and that the nipple will always present as red and shiny in genuine thrush cases. Neither of these things was true for me; I'd be interested to hear what other people's experience has been?

I can understand the need to rule out positioning issues which might cause ongoing problems, but feel that the material presented here is likely to shake women's confidence in requesting treatment, which is often difficult enough, given how sceptical some GPs still are about the problem.

Does anyone have any knowledge of how and why this new guidance was put together?

Thanks again for coming on, Wendy. Can I ask a couple of questions?

I totally get the need for caution, but I think you might be underestimating the ease of getting fluconazole prescribed at all - I found it a real struggle, and I do know of many people who never managed to and eventually gave up breastfeeding. How can you (as information providers) balance the need to not get it prescribed in excess or error with the very real needs of women for whom access to it would make it possible to maintain a breastfeeding relationship?

And the other one is about the one breast thing - I have absolutely no doubts that my thrush was correctly diagnosed and treated: I had no positioning or supply problems, and it responded very quickly to treatment. But the pain I felt was overwhelmingly on one side. Is it really possible to use this as a diagnostic criterion?

I do think that the Australian study has a very valid point which is why i have no gone back to thinking we need to swab baby's mouths and mum's nipples to be sure of diagnosis. Tom Hae did a study in US and proved he couod grow candida in breastmilk and do it readily even in presence of lactoferrin, but didnt grow any from mums diagnosed as having thrush.

so he concluded thrush in the breast didnt exist.

Not sure I'd go that far but I do think it is far less frequent than diagnosed in some areas and by some people.

Signing off tonight but happy to return tomorrow in case there are more questions. Wendy