Thrush and my knobber GP...

[Tinkerisdead]

Help. Dd2 is 10 weeks and about 10 days ago had thrush in my mouth. My gp prescribed nystatin and i asked what about treating me as im breastfeeding. Je told me to put canesten on my nipples which would be good for dd too as she'd have antifungal in contact with her mouth more too.

Fast forward to now. Dd is much improved but as fast as her mouth clears up its back again and im out of nystatin. My nipples are sore and im getting shooting pains in my boobs. Im pretty sure we're passing it between us.

I called again and said i think its in boobs and dd needs more gel. I asked about flucanazole and gp laughed. He says its impossible to catch inside your breast, that it cant affect milk. His advise is to hand express to flush out the fungus. He wont give me flucanazole in case it passes to dd in milk. Im on warfarin so i darent buy diflucan without gp advice.

Ive checked the breast feeding network advice and it says dont use canesten. It suggests flucanazole as well as topical treatments. Tried to discuss this with my gp but he laughed saying that was all based on guess work.

This is the same gp who told me to express when i queried antibiotic in my milk previously and couldnt grasp that expressed milk was still 'infected'.

What do i do? Is he right or has no concept of breastfeeding as i suspect? He has suggested formula on many occasion.

Thrush in her mouth not mine!

My experience of this is a while back but you can use canesten on your nipples and I had a gel for dd's mouth. Your milk is fine to use get in touch with your HV and create merry hell until they take notice, I had it for 6 weeks before anyone took any notice.

Sorry this may not be that helpful but didn't want to read and run, I know how much it hurts!

i wold see a different GP.

Im thinking of seeing a different gp but in our town there is literally one surgery for all and i wanted to check it was bullshit before i effectively went in saying 'your colleague is a right knob head'.

we have thrush also. Canesten says on the instructions not to ingest and go to a and e or something if you do. So I wash it off but how can you do that when out or if offering feeds on demand, sometimes every hour or two hours.

Flucanazole can be used in hospitals but unlikely via gp. Don't know risks. Seems to me it would be good to just get it over and done with in one swoop.
It can;t be good having weeks of sugary! nystan. Weaning tiny onto peppermint and cherry four times a day wiht the odd dollop of canesten when I forget to wash off. It make me sad.

My midwives seemed to hardly know about breastfeeding stuff and doubt most gps do either. The miconazole gel can't be used until 4 months. my gp didn;t know that when he prescribed it for example, and he didn't know why either.The are busy and 'general' and therefore imo nearly always out of date. It leaves everyone so helpless doesn't it?

I wondered if in my ducts also. Had a blocked duct for ages and was drained one day and then had deep shooting pains for a week then itchy and sharp pain on nipple and then baby oral thrush.

have you ever given a expressed bottle btw? I'm convinced I had thrush in me- i'm a bit of a thrushy person! but wondered if it might have been bottle.

Doubt diff. gp will have diff. opinion. I would print out the leaflet and take it in with you.

No no bottles i wanted to start expressing some for the freezer but i darent if it will reinfect dd later down the line.

God, what a wally. I would definitely see the other GP.

there's no reason to think that a different GP wouldn't have a different opinion.
I have met a variety of them over the years, some have been very anti fluconazole, others have prescribed it happily

the gel isn't supposed to be used on small babies in case they choke on it, although it is, IME, easier to use and and gives quicker results than the nystatin

oh last thing, when I went to our walk-in centre in agony and unable to feed my baby they rang the local maternity unit to ask them about fluconazole. the midwife told him it was fine, and he prescribed, so maybe that's something they could do if they are unsure?

also, one last thing, have you seen someone and checked the latch?
latch problems have almost identical symptoms to thrush and as such thrush is often mis-diagnosed. it's normal for your baby to have a white milky tongue. thrush generally looks "thicker" and you can't remove it by wiping...

Yes latch has been checked. This is def thrush i managed to take a photo in dd's mouth and its thick curd like coat on her tongue and patches on her inner cheeks. Right i'll keep on with the creams etc and ask to see another gp armed with breastfeedingnetwork info.

Im just so fed up because i bf dd1 for 6 months and would have done longer, this is really putting dd2 and i back with feeding. I had to express 24hrs worth of milk in 16 hrs when she was 5 days as i didnt want to use formula when i had a scan and now this trivial bloody ailment is set to put us on bottles.

I have been prescribed Fluconazole for thrush in my breasts before, several times. First of all it was a single dose - like you would get for vaginal thrush, then on a different occasion it was a 5 or 7 day (I can't remember) course, which were slightly lower dosage. It is possible. Go back to your doctor armed with info printed off the BFN or ask to see another doc.

Meant to say - the doc that prescribed it said if any did pass through into my milk, it would be such a low dosage that it wouldn't harm the baby. If anything, it would help.

I'm not sure if this will help... I have had experience of Fluc - where it made my DD very poorly - not everyone has the same reaction - also the doses and length of time you have to take it can make you feel pretty grotty too. Wr Wendy Jones (BFN Expert about thrush in breast!) suggested taking 3 x acidophillis to build up good bacteria and prevent future attacks of it - for me it seems to be working....

This again is also supposed to help with baby as the baby gets probiotic too and it is thought to be the best way to prevent both of you passing it each other.

Maybe an alternative method will help.

The gel isn't approved for young babies because of the choking risk, this is true, but if you spread it out properly in their mouth it's not a choking risk at all. It's only a risk if you feed them huge great blobs of it.

Poor you, I remember getting thrush after having mastitis...not funny!!
My GP told me it wasn't thrush as it didn't occur in breasts...stood my ground until he gave me the drugs!! later trained to be a BF counsellor but sorry can't remember all teh details for treatment as stopped 7 years ago. However do know Wendy as mentioned above is brill re thrush. Good luck :)

I hate thrush!! DS got thrush at 3 weeks and quickly passed it on to me. Luckily we have an excellent doctor who promptly prescribed fluconozole for me and daktarin oral gel for him. We also had some daktarin topical gel for my nipples. I breastfed whilst on fluconozole and DS had no ill effects from this. However whilst my thrush cleared ip quickly his returned as soon as we finished using the daktarin. There were no problems using the gel so long as it was applied in a thin later to avoid a choking risk. It's far easier to apply than nystatin which we also tried and absolutely hated the stupid runny stuff! I started taking lots of probiotics - tablets, powders and also in natural live yoghurt. As DS continued to have flare ups on his tongue I started giving him 1/2 teaspoon of probiotic powder once a day and within a week it was gone and now 10 months on hasn't ever returned. Maybe worth a go? Also I rinsed my nipples after feeding with diluted white vinegar as thrush doesn't like it. Also wash clothes which have touched contaiminated milk at 60 degrees. Good luck and you will get through this.

OP. I've had this 4 times, every time I've had to fight to get it resolved. Please print out the BFN leaflet. Get an appointment with the other GP and brandish it as evidence and get the meds you need. The levels of Fluconazole that enter the milk supply are lower than the prescribed amount allowed for preterm babies. The problem is that it hasn't been licensed for use by lactating women and it is effectively " on the GP's neck" if there were to be a problem. This is just an extra reason why GP's get antsy about prescribing!

If you take the leaflet brandish it and get nowhere then go to the nearest walk in clinic or wait until the surgery closes and ring the out of hours service.

Undeniably to those of us who have been there, you need treating, asap! Other than that acidophilus bifidus really does help, hang in there!!!

Poor you - I had a similar problem trying to get help for thrush. But I agree with what kickarsequeen said - gps are loathe to prescribe it off licence. But push - see a different gp for definite and complain to the practice manager about the laughing bullshit. Sadly a lot of gps are woefully ill-informed about bf. Do keep waving the bfn leaflet with the section for hcps. Also worth knowing that part of the pharmacist's job is checking what the gp has prescribed and they are responsible for dispensing! Good luck!

I'd ask for a diff GP!
I know some people think they're the work of the devil, but have you considered using nipple shields untill you're both clear of thrush? Lots of people say once you start with shields you can;t get off them again, but I started using them from birth because of flat nipples and got off them at 2 months.
Hope that's some use to you xx

am i too late to help = agree with incapinka post

fluconazole is good if you have deep breast pain as thrush can get in your milk ducts. however, the best treatment - believe me after 3 months of thrush i know,
constant washing boobs in vinegar
wash all milk touched clothes/bedding at 60
get yourself probiotic tablets - ones without milk powder in them take them daily - open a capsule and rub some in babies mouth.
buy grapefruit seed extract - make a strong solution - dab on nips after every feed (i also dabbed this in dd's mouth with cotton bud after feed too)
expose your boobs to air all night/day if you can
change breast pads fequently

sterilise dummies/anything that goes in babies mouth in milton - this kills candida albicans.

cut out sugar in your diet as much as you can and do not have any alcohol at all two things thrush loves.

you have to keep some of these things going because if you are pre disposed to thrush- it will come back, once its gone from your nips it sometimes goes somewhere else.

Try to stay positive - it can really get you down.
GOOD LUCK.

Thanks gem.

We seem to be getting better touch wood. Its def improved in dd's mouth and my nipples arent as sore. I'll start implimenting your tips to ward it off.

Your GP is indeed a knobber I have had deep ductal thrush at least once with each of my 3 DC. Canasten can be used on the nipples but must be wiped off before a feed. I was untreated with DC1 as the GP and health visitors didn't believe you could get it in the breast itself. With DC2 I self diagnosed and marched into the GP (moved GPs since DC1) with printed info and was prescribed nystan and fluconazole and it cleared up within two days. I couldn't believe how easy it was compared to the first time round.

However, for DC3 I had an antenatal pulmonary embolism and was on Warfarin post partum and fluc is on the list of must not combine with warfarin as it creates a massive hemmorage risk. So you will not be able to take it. Your GP will weigh up the benefits of stopping warfarin to take the fluc with what might happen if you stop warfarin - I don't think any GP will think bf is more important than risking clots or stroke (or whatever the reason you are on warfarin is). So for DC3 she prescribed Daktarin gel for DC3 and told me to use it on my nips and not wash it off. This was despite DC3 being 'too young' for the gel as she thought it was superior. It was way easier than the nystan and did clear us both up but it took longer than the two day wonder of fluc.

Best of luck with everything but do make sure you get good informed medical advice from someone who knows your full history.