Thrush in milk ducts ? no GP support

[Haylo]

Help l have an 8 week old and have had mastitus and antibiotics twice in the last 2 months, now certain l have thrush in milk ducts. No obvious signs externally on me (above or below) or on the baby. However pain horrendous during and after feeding, worse at night and very gassy baby who struggles to settle. GP has given me two topical creams in the last 3 weeks but no improvement, now on loads of pain killers to get through the feeds and after pains. l know it should not be like this as l fed my 2 year old for 8 months with no probs. GP will not recognise thrush can go into breast, or that l may need oral medication. Health visitor, NCT and La Leche local support all tearing their hair out but can do nothing to insist l get prescribed what they recommend. l really do not want to give up the feeding now because of my GPs lack of knowledge. Have been told no GP will prescribe oral stuff whilst feeding and my out of hours doc was similarly unsupportive. Having 8 week check with GP tomorrow, any suggestions ? sorry this is so long a post .......

Haylo, you don't need a prescription. You can buy the stuff over the counter as far as I know....expensive, though. Just ask the pharmacist.

What oral medication are your HV/LLL/NCT people recommending?
I had no trouble getting Fluconazole prescribed today, was also given Canesten cream & pessary and Nystan drops for DD's mouth.
I've been using Daktarin cream for me and oral gel for DD for the past 5-6 days but the pain hasn't improved. It's total agony esp on one side. I'm at the end of my tether in terms of endlessly applying creams, cutting out all manner of foods and sterilising everything I touch. And dreading each feed because of the pain.
Dr told me I can take paracetamol 30 mins before feeds so am going to try that.
You can buy Daktarin cream and gel over the counter. Have you tried it? Maybe if I'd persisted it would have worked... BF counsellor did tell me it would take 7-10 days but the pain did seem worse which is why I went to see Dr today.
Best of luck getting something that works. I wish I could say that I knew the answer.

Must dash but all my sympathy. I had this and it's a nightmare. Top up with pain killer, do whatever you need to.

This is a great link. It has sections you can print out and take to your doc because they really aren't across this issue at all.

Can you see a different GP? Not true that no doctor will prescribe you Flucanozole [sp?]

I got fluconazole but I had to fight for the right dose as detailed in the link I sent. Actually, in the end, it was homeopathy which sorted it for me but I attacked it on all fronts so it's hard to say what was definitive.

l have had two prescribed creams to apply after feeds for last 3 weeks, second of which was daktacort with no real improvement. GP has refused to prescribe fluconazole or anything else orally for me, only nystatin for my baby after senior community midwife intervened. Happy though for me to take loads of pain killers !! Because of his refusal to acknowledge this condition exists without externally visible thrush in me or babe, or to talk to the midwife (who is also my local area lead on infant feeding for health visitors) to educate himself, l am now having a referral to a consultant obstetrician to try and get the right meds - I AM DETERMINED NOT TO GIVE UP FEEDING BECAUSE OF HIS IGNORANCE.

I will report back on whether Fluconazole actually helps me. I'm outraged that you're having such problems with GP. Good luck and well done for sticking to your guns and persisting with feeding. I'm also determined that this is just a blip and I'm NOT going to give up and give her formula.

I had the same thing - GP refused to even believe thrush existed in milk ducts and prescribed me antibiotics for mastitis. Of course it made the thrush worse to have had the antibiotics.

HV then gave me and DS a prescription for Daktarin cream and oral gel (after a row with the GP!) but they didn't really do much.

Eventually I went back to a different GP and basically told her I wasn't leaving until she prescribed me systemic treatment ie flucanozole. She did in the end, after I gave her a leaflet I had about it. Apparently flucanazole isn't licensed for bf mothers but the amount that would actually enter the breast milk is less than the amount that IS licensed for infants. So it's a red tape issue - drug company not willing to spend the money to pay for a license for bf mothers as I understand it.

I had gone down to bf just twice a day by this point as it was such agony. Think things would have been different if GP had originally prescribed the right medication. Anyway, the GP seemed more inclined to prescribe when she knew I was just doing twice a day bf and suggested I took the tablets straight after my feeds.

Might be worth telling a little white lie??

Thanks for your posts, it helps to know l am not the only one experiencing this. My GP gave
me a prescription for the flucanozole today at our 8 week check after several calls from the area senior community midwife. Only a 50mg dose for ten days, but l will see how it goes, hopefully some improvement over the next 2-3 days with the pain to reduce the pain killers l have to take. Also baby weight gain checked today and only 3oz in 6 days, really hoping that the two bouts of mastitus and this thrush have set back the supply and now treated will pick up.

Good luck haylo. If the fluconazole doesn't ease things you may need a bigger dose and docs are reluctant to give it out as detailed in the Breastfeeding network link.

You may already know but it's also a good idea to cut out all sugar, alcohol and anything at all yeasty (bread etc) even though your body may crave it. The thrush itself craves to be fed so don't feed it.
Also eat loads of garlic and good quality probiotics with acidopholous bifodus from the health food shop.

I had it for about six weeks, which was awful. So painful. I was dreading every feed but we got through it ds and I'm still feeding him now (he's 2 ). I had to take pain killers during the worst days.

Anyway best of luck.

My DD has the worst gas, loads all the time and it really smells (TMI l know !) but l don't remember this with my 2 year old boy. Could it be the thrush in her gut ? are/have you noticed the same ?? she has been on nystatin liquid 4 times a day since Thursday of last week.

Haylo, is the fluconazole working?
My GP gave me 50g twice daily for 14 days. Five days on I can feel an improvement, thank goodness. I'm almost pain-free on one side now. I'm still using the Daktarin cream on me and gel on DD's mouth, and eating a strict no sugar/yeast/wheat/dairy diet.
Good luck with your treatment.

Thanks naturelover, after pains have stopped almost but actual feeding still quite painful at times on both sides, but have stopped the ibuprofen and now only about 2 paracetamol a day which is good. Have only had 50mg of fluconazole per day for 8 days now, daktacort for me and nystation for my DD.

To be honest the diet watching has been utterly C**p, l am craving the sweet stuff and bread.

Have checked out some alternative treatments today at the health food shop, will be quizzing the midwives about them at baby cafe this week and report back on what l might try of this course of treatment does not clear it up. Good luck with yours.

Re alternative remedies I was putting citricidal in water and it tastes absolutely disgusting. Am also taking acidophilus plus capsules from health food shop. Am eating lots of live yoghurt and probiotic drinks too. But it's hard not eating sugar and bread - I agree!
I'm glad the pain is easing. I've also managed to cut down on the painkillers.

How's it going Haylo?

I despair! Have finished the fluconazole and am sure the pain has worsened. I will have to go back to GP this week, and also bf counsellor as I have some issues with latch and she's very fussy at the moment. I started another thread about this the other day (Childbirth was easy compared to this...)

i had terrible pain much like you describe at about 8 weeks. my health visitor was straight on it, prescribed Miconazole oral gel and nystatin suspension for DD. I rubbed in the miconazole before the feed, she also had the drops after the feed. then i appled another cream to the area after her feed.
It took about a week to 2 to clear up. it was agony! i remember it more than the labour pains tbh.

sorry not much help, but i do hope it gets better. oh i also used lanisoh over hte nipples for to help with that pain, as they were roar and peeling afte a week.

naturelover hows it going ? l seem to have the pain only in my right breast, now have a 21 day 50mg per day prescription for fluconazole from the GP, he is reluctant to up the dosage. Have had my latch checked again, but sods law most painful feeds only occur at home and not with BFC or at baby cafe. l know its not the latch l am really careful to mirror the position from the left side which is pain free. However DDs weight gain has picked up which gave me the boost to continue but its damned hard !!

Hi,I'm new to the site. Looking for support and reassurance from other mums. Got a 7 week old baby girl. First baby. I am breast feeding. i have had a crack in one nipple for the entire time which wasn't healing and my health visitor suggested I might have thrush. My baby does have a small bit of white on her tongue and I since noticed that I do have shiny red nipples and they do itch. I also have a red rash that itches underneath one boob that I think could be thrush. I read this site thank god and went to my GP and we got a course of fluconazole tablets, daktarin cream for me and oral gel for baby. We are a week into it and my cracked nipple is healing slowly and no where near as painful but my baby still has the white patches on her tongue and seems niggly when feeding and makes moves with her tongue as if her mouth bothers her. I realise this is going to take a while to get rid of. Im washing my boobs in vinegar and airing them to dry and changing pads and washing everything at 60 etc etc but I just want it to go now, breast feeding is demanding enough without all this hassle. It makes me sad to think my baby is suffering. Ive started drinking yakult. Im wondering if I could put small smears of live yoghurt on my nipple before feeding her so she gets it in her mouth. I just want some support from anyone else who has been through this. Wondering how long other peoples babies took to get better and also could anyone else describe how their baby acted while feeding because mine is quite squirmy when she is feeding. Also, I've been trying to follow a well known authors book suggested routine for a 7 week old baby but not managing very well as we sleep to be so sleepy in the day and awake at night. routine...what routine!!!!

GEM - throw the book away or use it to raise a bed or something. Don't bother with routiens. Go with the flow.

I had thrush really bad in my breast tissue, all the way down to the bits of tissue that are under the armpits. It was bad, very bad. I took a print out from the breastfeeding support group as flucanazole had only just been okayed for bfing women at that point.

The bad news is that it didn't work for me. The good news is that the thrush eventually cleared up by itself after a couple of weeks.

Have you tried rubbing milk on your nipples after you've finished feeding, and allow to air dry before applying lansinoh? That really helped me.

Hey, that sounds awful! I have gone through 3 tubes of lansinoh. Someone said using lasinoh would keep the area moist which is what thrush thrives in so i've put the lanolin away! same really with the milk being left on the nips for thrush to thrive on the sugars.

How did the symtoms come out in you then did you have a rash or just pain inside?

Gem I had pain like hot needles in my boobs all the way down to my armpits. There was also whiteness around the nipple area. I did everything you're not supposed to do, no boiling bras, used lansinoh and breastmilk, etc. and it worked for me.

Yes, breastmilk contains a lot of sugars, but it also contains a lot of still unknown and amazing other stuff that helps the body heal itself very quickly.

I forgot to mention, taking a paracetomol half an hour before feeding also helped the pain.

OP, so sorry to hear you had so much trouble. Ductal thrush can be so so painful. I had it for several weeks when DD was 2 months old, along with two bouts of mastitis and I was very close to stopping the breastfeeding at times. I am so happy though that I persisted. DD is now 6 months old and the feeding is going so well.
I am also a GP and get so frustrated when I hear that some colleagues just won't acknowledge the existence of ductal thrush or listen to patients/colleagues. My suggestion would simply be to try a different GP as it is definitely NOT the case that none of us prescribe oral meds for ductal thrush.

I hope things work out for you.

Don't know if this has been mentioned, but raw organic coconut oil ( the kind that you can get from Holland and Barrats but even supermarkets do it now) works wonders when applied on the nipples and take 2 teaspoons orally. Also completely safe and no side effects. Cleared up my thrush in 2 days. Also works to kill all yucky fungus/ yeasts/ bacteria in general.( even works on those stubborn toe nail fungus infections). Make sure the coconut oil you're buying is labelled raw or cold pressed so retains its benefits and hasn't been over processed.

Having a real battle with thrush too - HV really helpful and thought it must be ductal. Had to convince GP to give me oral treatment. Signs have cleared up in baby, and have stopped treating her. But now I'm on oral treatment wondering if I should restart her treatment and cream on my Nipples even though no signs.
Smileybynature do you apply the coconut oil after every feed? Keen to give it a try.
Did anyone else think that their baby was a bit more gassy/sick/unsettled than normal? She seems OK at night but really struggle to get her to sleep in day and she seems quite windy.
Help!!

Esme85, yes, just reapply the coconut oil after every feed. Do try to make sure you keep the nipple area clean and wash the oil off properly ( in a shower) once a day as any remaining on there might go a bit rancid since it''s in a warm place and not taste very nice for the baby. Also something I find, cotton bras make all the difference and help clear up thrush as opposed to any bras that have high synthetic content that make the breast area sweaty and help thrush thrive. Also when the baby was very young and fed frequently, I found the cheap supermarket breastpads have always caused thrush to return. The 'closer to nature' ones seem to be OK. Half of the battle is prevention really. Also you'll be happy to hear in my experience coconut oil really dealt with the problem very quickly.