cracked, bleeding nipples + thrush! do i keep bf?

[jem1mapuddleduck]

hello. DS is 7 weeks old and have had ongoing problems bf. now have v cracked nipples that bleed occasionally leading to DS vomiting blood . i have had support to get good latch. have been on 2 courses of antibiotics to help cracks heal with no luck. Now have thrush! started medication for that 2days ago. Today the HV suggested i formula feed to allow cracks to heal, but i'm very reluctant to mix and don't want to reduce milk supply.
don't know what to do any more! i want to keep exclusively bf but don't want nipples to continue to get worse!
Has anyone experienced similar problems and found solutions?

oh poor you
have you tried using nipple shields? they can cause problkems, but I think in a situation like yours they could help perhaps?

also, has baby been checked for tongue tie???? both my boys were tongue tied and I had the exact same probs as you.

you must also be in terrible pain, maybe dreading feeds? i have been there but not with the thrush too, what a nightmare.

the vomiting blood is your baby getting it out rather than digesting so it is bad but not that bad.

you need to speak to/see a breastfeeding counsellor. here are links down the side and also get some lansinoh, nothing else is half as good.

what medication have you been given for thrush and what has your baby been given?

if you type thrush in the search box you will find some threads with advice on thrush. some mnetters have had success with taking fluconazol, which can be appropriate in your case. Personally I swear by dactarin for baby and clotrimatisol for my nipples. And fresh air and frequent clean nighties and bras. Do you wear breast pads? If you do not actually leak chuck them out as they keep it warm and moist for thrush to grow.

so if you were given ab the cracks were infected too? Poor you! unfortunately abs give you trush like you can't win!

I do sympathise. Being told to ff is not very helpful is it? I have not experienced more than just some itchy thrush, but a friend had bad thrush inside her ducts and winced her way through days and days of feeds but has breastfed happily for many more months.

I can give some suggestions for the thrush but not really the cracked nipples I am afraid. I think you may have to get rid of the thrush before you tackle your nipples again as I found lansinoh etc made the thrush much worse.

Some ideas to try (mostly taken from the current La Leche League leaflet):
Daktarin/Clotrimazole for you, apply a pea sized amount after every feed
Flucanazole for you (if you are feeling deep breast pain, not just in your nipples) 150mg loading dose plus 10 days of 50mg twice a day
Nystatin for baby, 4 x 1ml each day, coat the whole mouth with a clean finger (micanazole/daktarin gel is no longer prescribed for babies under 4 months)
Disilled vinegar solution (1 - 2 tsp per 160mls of water) applied as often as possible to your nipples with a clean piece of cotton wool for each side
Clean towels after every shower, plus clean pjs and bras, I ironed my bras and pjs at a high temp as I couldn't wash these hot enough
Plenty of handwashing
Acidopholus tablets, 1 tablet twice a day
Grapefruit seed extract 250 mg three times a day (or the equivalen if you get the liquid)
Garlic capsules, triple strength, 3 tablets 3 times a day

My advice would be to feed as much as you can bear but express when it gets too much (or give formula if you can't express). Even when it is mega painful be very careful of how ds latches on as I got slack and it made everything much worse. Definitely try nipple shields but I found they didn't cover the most painful bit. I wouold really go to town on the thrush treatments as the longer you leave it the harder it is to get rid of. As soon as it is gone lansinoh for your nipples oh and bf counsellors to work on latch again.

I had cracked nipples, which bled...and every time dd latched on there would be this searing pain like someone was rubbing glass into them. I used to have tears rolling down my cheeks.I put really thick cream on (sorry have forgotten name but it was easily available in UK and was for this purpose). A breastfeeding counsellor said don't put anything on them except breast milk and to let them air-dry...which actually made them drier and much worse. An old-fashioned midwife advised the cream which moistrised them and stoopped them cracking as much..they became more flexible IUKWIM..at least the skin did. It all cleared up after 4 weeks of using cream. I continued with breastf-ing throughout and it was a bit of a pain cleaning off cream so dd could feed bt well worth it. I b-fed mine both for at least 10 mths then. Really feel for you, I do as I know what you're going through.

thank you so much.
I am on fluconazole (started with a 150 dose and now 50 twice daily as you mentioned) and have clotrimazole cream for my nipples. DS is just having canestan rubbed into his nappy area - i'm not sure if he has it in his mouth, there are no white plaques etc.
I have also been adivised hydrogel wound dressings for the cracked nipples but perhaps this should wait for the thrush to clear for similar reasons as anchovie mentioned with lansanoh, making it moist warm and worse!
yes we checked tongue-tie and i'm fairly sure he's not.
I find he doesn't get as much milk when i use nipple shields, and comes off sooner. has anyone experienced this or am i being paranoid?

We only did dds bottom at first but was wary of passing it between us hence the nystatin. Can't help with the nipple shields I'm afraid, made dd fuss which made everyhing hurt more. One thing I forgot to mention which I think was what got me through it was 400mg of ibuprofen 3 times a day, numbed the pain enough to keep it bearable. Good luck, you are doing so well to be sticking with it!

Poor you, but great job sticking with it this far - I was/am in the same situation, although with improved latch and different positions, I've had most of the cracking go away and am now just still struggling with very stubborn thrush in both the nipples and the milk ducts. It has been horrible (and easily far worse and extended pain than the labour!), but it is starting to improve and the fact that DD (now 6 weeks) is thriving on the breast milk has gotten me through the worst of the pain (along with my general stubborness, paracetamol and a fair number of tears).

I'm doing everything that anchovies lists above to clear it, although had the GP up my flucozanole dosage to a 300 loading dose and 100 2x/day after a week at the lower dose made no difference.

I didn't try expressing, FF or nipple shields because I was too scared to do anything to effect my supply or her technique since the fact she was doing so well was what kept me going, but I'd say do whatever you need to to get through the worst of it.

Good luck!

if you are being treated for thrush then you HAVE to treat ds in his mouth as well.
it does not always show as white patches.

he could easily have it with no obvious symptoms and if you don't treat it he will pass it back to you

Poor you, thrush is sooo painful
I would recommend taking painkillers and trying to carry on feeding from the breast if you can

I had it with both DC and for the second I tried Grapefruit seed extract tablets
www.bodykind.com/productdetails/CatIDx275/ProdIDx959/citricidal-grapefruit-seed-extract-100-1x.htm
I am generally skeptical of alt health stuff but they did seem to work much quicker than daktarin

This is an info link from kellymom
www.kellymom.com/newman/c-candida_protocol.html

For the cracked nipples try not to let them dry out, use lansinoh or another nipple cream
www.leron-line.com/updates/Wound_healing.htm