Breastfeeding and looks like DS has thrush - what should I do?

[liquidclocks]

DS2 (3 and a half weeks) has a white film that won't wipe away on his tongue which I'm pretty sure is thrush (DS1 had it around the same age). The difference is that this time I'm BF. I'd been having a pretty painful time up until about 5/6 days ago when it improved a lot and now it's become very painful again and my boobs hurt for an our so after each feed/expressing-

Does this mean I have it too and should I carry on BF or exclusively express for a while? (I can express plenty so not a problem)

Also how quickly should I get treatment - can it wait until Monday when the HV comes?

Feel so - it was going so well! But I know you ladies will give me good advice so thanks in advance

Sorry - 'our so' = 'hour or so'

Sounds very much like you both have it. Bound to really if he has it - its highly contagious.

I had it with DS and after ages of being told the pain was most likely from poor latch they finally discovered we both had thrush. Get tmt asap because it certainly wont feel better until you do. Where you could get that from at this point in the weekend i dont know.

What you can do is take ibuprofen as a painkiller. Its an anti-inflammatory so helps tremendously. Take it 15-30 minutes before a feed.

Dont worry - its not your fault, you havent done anything wrong. As soon as you start treatment improvement starts immediately. He needs an oral thrush treatment such as Nystatin, and you need Daktarin cream for your nipples and possibly fluconazole (i think its called) as well.

You will need to boil wash all your bra's, and anything else that comes into contact with b/milk or his mouth (ie dummy - washable b/pads etc).

Hope it gets better soon.

The Breastfeeding Network have very good info on this. You need to tackle it seriously and quickly because it can spread inside the ducts which hurts like hell.

It can also lead to very sore cracked nipples.

Good luck.

Thanks both - why do these things always seem to happen at the weekend!

The other thing is I do stil have the nystatin that DS1 had and the expiry date is 06/2007. DH is all for giving it to DS2 but I'm not so sure as it's prescrition only - what would you do? I don't think it would help long term as it seems we both need treatment really.

You could always phone NHS Direct and ask for their advice but I think you need to get prescriptions ASAP for both you and your baby. If your baby has thrush then you both need treatment as you will most probably have it on your nipples too. Think you get some kind of anti-biotics and your baby will get drops that you have to give him before or after each feed. If you've both got thrush then it's not going to go away until you've been treated so I think the option of BF or expressing is probably up to you depending on whether you can cope with the discomfort during/post-feed.

I had chronic thrush on my nipples with DD1, 4 years ago and they ended up cracking beyond belief and not healing (one of the tell-tale thrush signs I understand). The pain of trying to feed was excrutiating - it was like your baby had your nipple gripped with a mouthful of glass splinters and was sucking HARD. I know that one of the worst things you can do with thrush is to express milk to put on your cracked nipples and to air dry them, in the hope of helping them to heal, so don't do that in any circumstances!

It doesn't mean the end of breastfeeding, you can work your way through it with your doctor's help, but I would really urge you to seek help sooner rather than later.

Good luck.

ouch!

I'd guess they'd not be overly keen to give baby treatment as he's so young and its so common in BF babies - my LO (same age) had a coated tongue like this and my GP gave me nystatin but advised to wait a couple of days before using and use cream on my boobs. It cleared up without needing to treat him. You could start by putting some canesten cream on your nipples between feeds. If expressing is less painful then do that for some feeds. Plus get the air to your nipples - no soggy breast pads, sleep with your top off, walk around the house topless as much as possible.

When i had it shortly after birth they gave me cream straight away, gave me rubbish gel to put on babys tongue which just stayed on my finger, so I got rid of it quickly only to be reinfected by baby. They can give u some cinnamen liquid to give to baby which is much easier to give than gel.

I don't think there's any point in you giving your baby the medicine without you getting treatment too, so I wouldn't give him the nystatin at this point.

Forgot to mention that you should also change your breast pads after every feed.

Why don't you give NHS Direct a call? Alternatively, if you call your doctor's out-of-hours/emergency number then you can get the on-call doctor on the phone and if you explain what the problem is then they might be happy to go ahead and fax your prescriptions to a local 24-hour chemist for you to collect. I think most doctors are pretty sensitive towards the needs of mums/new babies and wouldn't question you using this service ... if it's available to you in your area?

just reread that - should read that 'it cleared up without needing to treat him as I was using an antifungal cream'

Hmm, I wonder how DH would take to me wandering around topless

...maybe he'd be less keen once he'd seen me leaking!

I'm not sure if we have a 24hr prescription service, we're a bit behind the times up here. Will give NHS direct a call though, perhaps they will know. Thanks for the advice - reading the stuff on the breatfeeding network site has got me a bit worried and it sounds like it would be best to try and nip this in the bud before it gets any worse.

Does anyone know how it happens so I can stop it from happening again - everything I read says it's not due to poor hygiene but then advises you to take extra care handwashing and sterilising ?

I was told DD was born with it, an infection she caught at birth. I was just told to change breast pads all the time, wash breasts all time, don't use scented soap.

Think that it's one of those things that some people are more prone to than others. It's not poor hygiene I don't think BUT once you've got it then you have to go overboard on handwashing, bra washing, nipple pad changing, sterilising etc. from then onwards.

I don't think it's something you need to unduly worry about, it's just one of those things that you have it, and now you need to get it sorted asap in order to nip it in the bud as you say. Your baby will be fine and you will be fine and you will be able to carry on breastfeeding but you just don't want it to get any worse, because worse is bad!

By the way, IMHO, as you are feeding your baby I wouldn't go putting any kind of creams on until you've spoken to a doctor. You may also find air-drying painful as if I remember correctly, thrush can make cold air uncomfortable on your nipples.

Dump the Nystan - buy Daktarin Oral Gel for the baby (over the counter no need for prescription) and Canestan or Daktarin for your nipples. You absolutely MUST treat baby and nipples simulatneously otherwise it will never go away !
I had a lot of success with Daktarin after reading the BFN info. Nystan is sugary rubbish prescribed by most GP's and basically doesn't work.

Try putting the oral gel on baby's tongue and gums with a cotton bud, otherwise the gel tends to slip off your fingers when applying it.

Sympathities and good luck

Exactly what yellowrose said.

It's a bore, but stick with it, it will go away.

Absolutely agree about nystatin being useless and Daktarin being the best stuff. The good thing about putting Daktarin on your nipples is that you don't have to wipe it off before feeding as it is designed to be taken orally anyway (as opposed to Canesten). Just make sure you ask the pharmacist for the oral gel and not the athlete's foot treatment .
Kellymom.com has some good info regarding thrush,here
Cutting down on sugary foods (including fruit) might help prevent recurrence.

Liquidlocks - very sorry to hear you have this, it is excrutiating (I remember that feeling of crushed glass passing through my nipples each time I fed DS and I had to walk around the house with no top on for days - even water hurt when washing).

I had it 4 times in 4 months and each time due to having taken antibiotics (for mastitis).

Nystatin does work but it takes 7 days to start feeling the benefits. We had Nystatin for me and Nystatin mouth drops for DS.

TBH if it was me I would use the old Nystatin this weekend and then get a prescription first thing Monday morning. You need to act sooner rather than later as it gets worse when left untreated. I carried in BFing throughout the thrush and after and I always kept some Nystatin in the fridge, in case it returned so I could nip it in the bud.

Good luck!

Thanks for all the tips - you've made me rember that DS1 did have daktarin after the other stuff and it did work quicker so I'll ask for that.

I rang the GP out of hours service and I have an appt tomorrow morning to go and get a medial opinion and prescription. However, I will be taking a printed off version of the breastfeeding network leaflet as when I rang up, the nurse said 'ooo, thrush in your breast, I've never heard of that - do you think you might be confusing it with mastitis?' - I thought breastfeeding thrush was quite common???

Just expressed enough for both night feeds and hopefully we'll get sorted out tomorrow!

Liquid - you're wise to take the print off, my GP didn't have a clue either and I had to tell him what to prescribe after reading it on the internet.

I definitely will I have a great GP but I still had to take him all the literature about safe meds when breastfeeding to get stuff for my migraines. Sometimes they just need a bit of help!

PS - love your spooky name - my creativity has given up and couldn't think of anything halloweeny

liquid - you are lucky to have a good GP who is OPEN to being told they are wrong sometimes !

Mine has never heard of "breastfeeding" (now I am on her list of weirdo's for bf a toddler !!) never mind explaing that some meds. ARE safe when you bf

Shame it wasn't my own GP I saw this morning!

Just to update you all, say thanks and to have a much needed rant here's what happened this morning.

Went to out of hours GP who told me thrush doesn't really need to be treated in a newborn unless it's affecting their feeding - but he'd prescribe nystatin 'just in case'. He then told me that the pain in my breasts is because of engorgment and I should be making sure baby empties the breast fully each time. When I questioned him and asked about reinfection and treating my nipples as well he said not necessary. So, not very happily, I presented myself to the midwives at delivery suite and they were slightly more helpful in that they actually looked, checked my latch and asked lots of questions. But as there's nothing to see on my nipples there's nothing they can do (? Does there have to be something to see?).

Anyway p'd off with the NHS I went to boots pharmacy and asked the pharmacist what he thought. He said 'of course you need to treat your breasts - it's spread by spores and you'll just reinfect the baby if you don't' - THANK YOU Mr. Pharmacist! - So I've bought the daktarin gel and I'm going to do what the breastfeeding network leaflet recommends. I know there are some really good doctors and midwives out there but WHY when you REALLY need the help do they all go into hiding???

If you read this far thanks for listening to my rant - feel much better now! Off to put gel on so hopefull my breasts can start to feel better too

Your pharmacist sounds on the ball. Funnily enough, I have been given fantastic advice by my local pharmacist too, on several occassions when I had totally given up on my GP and HV. I think it must be because lots of mothers go into a pharmacy looking desparate and these guys know more about the contents of medication than the average GP. They also know about what meds. are safe when bf, have asked several times and then double checked with kellymom.com and they were right !

The exact same thing happend to me. After self-diagnosing my DS with thrush (thank goodness for the internet !) GP gave me Nystan and NOTHING for my boobs. When I said what about my boobs, she said, oh, ok, well then, have some Canestan for that too if you really need it I had horrible shooting pains in my boobs, so yes did need it !

Liquid - if you need any more help and support please come back here and we will all try to help.

Just keep using the Dakatrin gel and put something on your boobs after each feed. Don't stop until it clears.

A solution of 1:10 white distilled vingar to water does wonders too if your boobs aren't cracked (oooouuuuchhhh !!) Dab some onto each nipple after each feed. Thrush dies very quickly in acidic environments and thrives on sugar. Agree that you should try and cut down on sugary foods until it clears up.

Thanks yellowrose. I'm really wary usually of self-diagnosing as I hate it when my own patients do it (I'm an OT when not at my 'real' work of being mum ) but I felt left with very little choice today. Thank goodness for good pharmacists!

And Mumsnet!

liquid - yes self diagnosis can go horribly wrong - but not when you have MN and other good sites like kellymom.com to back you up !

Ds2 was given nystatin from 5 days old, we went through 1 and a half bottles of it but it had no affect on him, then told to use daktarin on his tounge, we did this for a week but it still didn't clear. I was never told to use anything on my nipples though . We stopped using medication and it appears to have got better, ds2 is now 9 weeks.