Nipple Thrush won't go away

[dash26]

I've had nipple thrush since DD was about 3 weeks old, she is now 12 weeks and I still have it. DD also had it but it finally cleared up a week or so ago after wiping her tongue with medical gauze before applying Daktarin Oral gel 4 times daily.

I have tried absolutely everything. I am using Daktarin cream after every feed and am on my 3rd course of Fluconazole. I am washing everything that touches my nipples on a hot wash, I'm taking acidophilus and actimal daily but it just doesn't seem to be going.

My swab results came back as no Candida present, but I had to swab myself at the GP so am not sure I did it correctly. A lactation consultant has told me it is definitely thrush, my symptoms are bright pink shiny nipples, discolouration of areola, sensitivity when anything touches the nipple and stabbing pain in nipples and deep in the breast.

I'm worried I am going to pass it back to DD, does anyone please else have any other suggestions of how I can finally be rid of this....Otherwise I am probably going to have to give up BF.

[RudolfsLeftToe]

Can you ask for a different prescription? I was prescribed Miconazole which might be worth a go? It was 9 years ago now though so can’t say for sure that it’s still ok for breastfeeding mums. I really hope it clears up for you because I found breastfeeding so easy once the teething (ha!) problems had settled down.

[dash26]

@RudolfsLeftToe

Can you ask for a different prescription? I was prescribed Miconazole which might be worth a go? It was 9 years ago now though so can’t say for sure that it’s still ok for breastfeeding mums. I really hope it clears up for you because I found breastfeeding so easy once the teething (ha!) problems had settled down.

Thanks for your respons.... The Daktarin cream that I am on is Miconazole. I am now trying coconut oil.

Unfortunately I have now reinfected DD after hers disappeared following the Daktarin Gel. I'm at a loss now.

I do think it's to do with a bad latch, but she has had tongue tie division and lots of help from a lactation consultant and I just can't seem to get her to improve her latch, I've tried everything. I'm really sad to have to give up BF but I can't see another way, I've been in agony with this for 11 weeks now.

[Doyoureallyhavetoask]

https://www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/breastfeeding-problems/thrush/

NHS information suggests that some women with this will need tablets as well as cream

[Gunpowder]

Coconut oil helped me. There is a (albeit small) study showing it can be effective.

[stayathomegardener]

God I had this 24 years ago and still remember the pain.
I did give up breastfeeding despite driving dd down to a specialist clinic at John Radfield?
Really wish we'd had her tongue tie treated at the time because it still causes her issues now x

[Doyoureallyhavetoask]

Ah sorry have just seen you have already had fluconazole

[Jasperz]

APNO is your friend. Ask you gp to prescribe according to the prescription, then go to a compounding pharmacy to get it prepared. Absolute magic stuff

https://www.verywellfamily.com/dr-jack-newmans-all-purpose-nipple-ointment-431885

[Frlrlrubert]

I can't help if it's thrush, because what I had was Raynauds, in my nipples.

I had all the thrush treatments, which made it worse, and only 'clicked' when a bf counsellor made an offhand comment. I may have initially had thrush, but it went in and on and by the end I definitely didn't, but still had symptoms.

It's discussed here under 'vasospasm'

llli.org/persistent-pain-when-breastfeeding-2/

Basically, stopping putting daktarin on my nipples and wafting them about and wiping them and all that, plus being a bit more conscious of the temperature, solve a problem that almost had me giving up at 6 weeks.

[sandberry]

It sounds highly suspicious of mammary dysbiosis (subacute mastitis) especially if the swabs are negative for Candida.

Basically due to subacute infection the milk ducts become narrowed causing deep breast pain that is almost constant. When there is a milk ejection reflex, due to the narrowed ducts you experience sharp shooting pains. This is often mistaken for or genuinely follows on from a thrush infection and so is treated as thrush.

The bacteria is usually antibiotic resistant but targeted probiotic therapy has shown a lot of promise. You can confirm with a milk culture which could also confirm or exclude thrush

Theres more information here
https://connect.springerpub.com/highwire_display/entity_view/node/92657/full

you might also find the Academy of Breastfeeding medicine protocol on persistent nipple and breast pain useful
https://www.bfmed.org/assets/DOCUMENTS/PROTOCOLS/26-persistent-pain-protocol-english.pdf

if you’ve had a generally difficult breastfeeding journey with tongue tie and poor attachment then mammary dysbiosis is quite likely.

I really hope you do find a solution because persistent pain is really hard.

[dash26]

@Jasperz

APNO is your friend. Ask you gp to prescribe according to the prescription, then go to a compounding pharmacy to get it prepared. Absolute magic stuff

https://www.verywellfamily.com/dr-jack-newmans-all-purpose-nipple-ointment-431885

I asked my gp to prescribe me the APNO and they wouldn't they instead gave me daktacort which is the miconazole with hydrocortisone in, this again did nothing. So frustrating as I do think this would help.

[dash26]

@sandberry

It sounds highly suspicious of mammary dysbiosis (subacute mastitis) especially if the swabs are negative for Candida.

Basically due to subacute infection the milk ducts become narrowed causing deep breast pain that is almost constant. When there is a milk ejection reflex, due to the narrowed ducts you experience sharp shooting pains. This is often mistaken for or genuinely follows on from a thrush infection and so is treated as thrush.

The bacteria is usually antibiotic resistant but targeted probiotic therapy has shown a lot of promise. You can confirm with a milk culture which could also confirm or exclude thrush

Theres more information here
https://connect.springerpub.com/highwire_display/entity_view/node/92657/full

you might also find the Academy of Breastfeeding medicine protocol on persistent nipple and breast pain useful
https://www.bfmed.org/assets/DOCUMENTS/PROTOCOLS/26-persistent-pain-protocol-english.pdf

if you’ve had a generally difficult breastfeeding journey with tongue tie and poor attachment then mammary dysbiosis is quite likely.

I really hope you do find a solution because persistent pain is really hard.

Thanks for the detailed response...it does sound similar for my symptoms but I just can't see how I wouldn't be thrush, every symptom I have read for it I have plus now the thick white coating on DDs tongue has returned and her wind is quite smelly again.

However I just don't know how I am ever supposed to get an accurate diagnosis, my GP didn't even look at me or DD and I had to pass them a letter from a lactation consultant to get them to prescribe the correct medication as before this I was told to put Lanisoh on, which I now now would make the thrush much worse.

[DeathMetalMum]

Has GP prescribed Nystatin for dc? It's alternative to daktarin gel and usually fairly effective. If you have a prescribing pharmacist locally they should also be able to prescribe for both you and dd if your GP isn't helpful.

It may be that while dd's symptoms eased the thrush wasn't fully eradicated hence it's quick return, and your difficulty to clear your infection.

[Lelemol]

I have exactly the same issue as you, I discovered I had nipped thrush when my baby was 3 weeks (she’s 12 weeks old now) because of the terrible pain, my nipples were discolored and very pink I went to the doctor and they told me I didn’t have it. I was convinced so I went to a few more until I got Fluconazole prescribed I started with a 400mg dosis for the first day and after 200mg for 10 days, then 150mg for an other 20 days and I’m very disappointed because it hasn’t completely disappeared, I’m in the first pill of 10 more of 150mg, my pain has subsided from a 9/10 to 3/10 but I’m still in treatment for that. My baby still has the oral thrush and I’m giving her nystatin, I was told by my doctor that sometimes when the fungus it’s deep in the breast ducts it takes longer to treat. Oohh something also important it’s that My milk sample was negative for candida but my baby has it so the lab test was not taken in count for a diagnostic because if your baby has it it’s because you have it as well.

just be persistent and patient.
its not easy but it’s worth it!

[Vdot]

Hiya - just going through a similar thing, had thrush since week 3 and we are now week 5.5. I’ve had miconazole for myself and baby and 17 days of fluconazole with pretty much no change to symptoms. Surviving by taking ibuprofen regularly. Is there any light at the end of the tunnel - did yours go away or did you stop BF?
Thanks x

[Lelemol]

Hi there, it will get better, my pain went completely away after literally like 4.5 months, my doctor said that now thrush it’s very resistant to medication, I was taking paracetamol instead of ibuprofen, during my treatment the pain was getting better but in a very slow pace, sometimes you feel way better and then you feel it gets worse for a whole week and then you feel better than before, I don’t understand. It’s so weird. I hope you get better soon, remember to boil everything after you and your baby use it as pumps, bottles and pacifiers.
just be patient it’s a long way to go.

[dash26]

Hi @Vdot the pain did eventually go away I would say when DD was about 4-5 months old. I stopped breastfeeding at 7 months but not due to the "thrush".

I now don't actually believe me or DD ever had thrush, and I think DD had a severe case of milk build up on the tongue due to poor latch, and my pains were a mixture of dermatitis and bad latch causing shooting pains, hence why the medication never really worked and most importantly both our swabs from GP came back negative.

There was an article I read a few months ago that basically said thrush is one of the most over diagnosed conditions in mothers, and that there is no evidence that thrush can transfer to and from mother and baby. I follow a lactation consultant on instagram who explains this all, I would really encourage you to watch the below posts.

https://www.instagram.com/p/Cyik4BONdYr/

https://www.instagram.com/p/C3LjH9MtQM7/?img_index=1

[Vdot]

Hiya, thanks both for the replies - super useful and I think you’re right it’s not thrush and the creams were making things worse. Going for possibly mammary dysbiosis and seeing a lactation consultant tomorrow and taking prebiotics and probiotics.. that Instagram account is really useful thank you!!