Out of hours GP for thrush - inappropriate?

[PogoBob]

Am 99% certain 3wo DS and I have thrush (had it DD and remember the symptoms/pain well).

It is agony, I can't feed off the right hand side and DS is really out of sorts when feeding, wanting to feed constantly but then pulling off and fussing so think his mouth most be sore.

Have tried expressing and giving a bottle but he won't take it.

Thinking of calling the OOH service in the morning but my GP's website goes on about the service being for emergencies or urgent cases only - does this count or am I being a wuss?

Don't want to waste resources but not sure how much longer I can cope.

Go. He's 3 weeks old and not feeding properly!!!

Call them, this is your baby's only source of nutrition, it needs sorting ASAP.

Call NHS Direct. They will tell you what to do. This is exactly the type of thing they are there for.

Call them now - your baby needs to eat, and you are in pain

Thanks all, DS feeding properly is obviously critical, just wondered if U should be able to suck it up until Monday.

Have managed to breath my way through a feed off the sore (and rather full) side and it's knocked him out so going to get some sleep and will phone them in the morning, which will probably be around 4am given his recent track record!

Thanks again

Not inappropriate at all. Good luck

You could just buy the nessersary treatment OTC.

Gp here, just call them it's no problem!

You should be seen. Mastitis could be possible if not thrush and if that painful you need treating asap. Print off leaflet frombreast feeding network website on thrush as gives doses and treatments for u and baby there and the bnf (our dr drug book) is rubbish at guidance on this. You can't buy treatmemt for breast / baby thrush otc as both are off license prescription anyway and you'd need 10d course fluconazole once a day and baby some daktarin gel 4 times day over gums and tongue after feed. But as i say from your symptoms could also be mastitis with blocked duct so get seen...this is urgent as can get a lot worse without treatment. Hope you're feeling better soon.

If it def is thrush then the post above is great advice, I needed two courses of fluconazole to shift my thrush, but have seen lots of friends fobbed off with thrush cream for nipples & told to boil wash bras. I don't think that works if the the thrush is in your milk ducts but lots of gps don't seem to agree & you may need to push for the right treatment. But fine for out of ours gp I think, esp if you are in lots of pain.

Tbh, I never understood the point of OOH GPs (if its an emergency isn't that what A&E is for?) and then I had children...

Some things are not immediately life-threatening but equally you should not have to wait for treatment. This is one of those times Pogo, for your baby at least, if not for you.

Hope you get some good meds.

I would be surprised if any GP would go for oral fluoconazole as a first course of action with such a small baby. They'd go for the topical stuff which you can get OTC - not sure why a PP thinks you can't. Daktarin Oral Gel for baby (four petit pois sized blobs four times daily - one blob each in cheeks, roof of mouth and tongue) and Daktarin miconazole cream for you applied after every feed.

I agree that you need to get mastitis ruled out, but TBH you could get everything you need OTC then just wait for the regular GP if you really feel you need fluoconazole. Most GPs prescribe the incorrect topical treatments anyway (they always go for canesten and nystatin, if it even occurs to them to treat mother AND baby at all...wrong, wrong, wrong)

I wouldn't waste your time, buy some oral thrush gel otc as soon as the chemist opens and use a bit on your nips and only use a little in babies mouth

Just remembered, why not try your hv? In some areas they can prescribe the stuff themselves

Hi pogo
I remember that thrush pain and it was 4 years ago! Get yourself to ooh, and get some relief before it spreads to the other side.

The oral gel doesn't penetrate the skin of the nipple the way the miconazole cream does. It's also possible to get Daktacourt which is miconazole cream with steroids in it to provide pain relief. You would have to wipe it off before every feed.

Just remembered, Daktarin oral gel isn't recommended for babies under four months so a pharmacist may get funny about giving it to you if they happen to ask the age of your baby. It's still the recommended treatment over nystatin, according to the BfN. The issue is that as it's a gel rather than drops there's a minor choke hazard - GPs will sometimes refuse to prescribe it for this reason as well. Just make sure you smear your blobs a bit before applying and rub them into your baby's mouth well then keep your baby upright for a bit afterwards.

Yes op, if you do go otc don't say its for your baby or they will act as if you've asked for a pack of cigs instead. The gel has the same active ingredient as the cream and worked a treat for me, meant I didn't have to wipe it off before a feed. but I guess the cream might work quicker

I would be wary of an ooh GP knowing what to do. Can you print off a leaflet to take? I think I'd buy otc and wait til monday, but nothing wrong with ooh either

I would be wary of an ooh GP knowing what to do. Can you print off a leaflet to take? I think I'd buy otc and wait til monday, but nothing wrong with ooh either

Elphaba....i'm.a gp that would prescribe fluconazole if i felt it was in the ducts as miconazole cream is unlikely to penetrate deep enough..safe for baby according to mhra and dose received via breast milk is less than dose a premature baby would have prescribed for them to receive directly.
Thanks for your confidence in gps :( although yes i have seen colleagues who were not up to date in their advice hence my suggestion for op to print out bfn leaflet as has section for health care professionals.

We cannot diagnose over mumsnet and sadly i've seen ladies self diagnose with thrush that was mastitis that needed antibiotics who were v unwell with it. It is better for op to see a rl gp who won't mind in the least checking her over today esp in the delicate stages of breast feeding at 3 weeks. Also baby needs mouth looking at to see if is thrush before starting treatment....to save needles treatment if not.

Hope all sorted soon op and you feel better soon. Had this myself at your stage and like another poster took 2 courses of fluconazole to clear.breast fed until 15m so worth persevering....just telling you that as had 1 patient told to stop breast feeding due to it by someone which would have been a shame had she listened to them as she very much wanted to continue.

Needless not needles.....that would be ott for thrush sorry for typo!

Sorry for the no-confidence motion mmmmsleep I'm sure you're one of the good ones. You hear of some truly daft thrush advice given both on MN and IRL, though, not to mention some bloody awful practice. One lady on here felt she had thrush and not a single GP in her practice would entertain the notion, despite being presented with the BfN advice, as they didn't think it existed. I told my GP I thought I had thrush. She didn't even check me or my baby - just prescribed Daktarin oral gel for him and canesten for me. I went for a check with the BF specialist with my multitude of other problems, who tore her hair out at yet another GP both prescribing incorrectly and not checking in the first place. I was then put in the awkward position of having to argue the treatment with the GP, especially when it wouldn't clear with topical treatment and fluoconazole was the next step (she wouldn't prescribe it until I read the leaflet aloud to her over the phone and provided her with the link).

Fortunately as a clinical specialist inpatient OT I'm used to having knock-down-drag-outs with consultants on a daily regular basis, but many women would still just follow 'doctor knows best' advice and possibly chuck in BFing as a result.

But then GPs have so much bloody guidance chucked at them on an hourly basis, plus with commissioning now as well, it's a miracle how you keep up with any of it. again.

Thanks all, have an OOH appointment at 11:30 so fingers crossed

Good luck - I've just finished a 10 day course of flucanazole, which has helped, but I also have issues with vasospasm/bad latch which doesn't really help!

Thanks elphaba. Sorry to hear you had a bad experience yourself. I know we're not all great and sometimes i hear stories that make me embarrassed for my profession.i just get frustrated sometimes getting constant daily mail bashing when i'm working flat out to do my best and missing putting my dc to bed etc. I do love my job. It's a complete honour to get to share peoples lives and help them when we can. You're right it's tricky to stay up to date with every area of medicine/comissioning/employment law etc so sometimes we fall short but i certainly will keep trying to be one of the good ones. I'm sure you have your fair share of issues as an OT with all the nhs cuts.
Op hope your appt went well and you feel better soon.