Wit's end- pharmacist giving great advice (not)

[MamacitaGordita]

I've posted on here a bit recently regarding my agonising nipple pain at 9 weeks- baby has no symptoms of thrush but I started feeling sore after abx and a bout of vaginal thrush. I now have hellishly sore nipples, one cracked, and have sought advice from BFC who suspected it might indeed be thrush. So today I spoke to my HV who said she would organise the relevant prescriptions for me.

My DH picked it up and arrived home with- 150mg capsule fluconazole. And... nothing else. He said that he asked the phamacist was there nothing for baby as surely they would pass it back and forth (clever DH) and the pharmacist said no, you see what your DW should be doing is washing her breasts with soapy water before each feed. I burst into tears at hearing this news. This advice went out in the dark ages and I so wanted to start treatment tonight. I had a look at the Breasfeeding Network advice leaflet on thrush and they recommend a loading dose of fluconazole and then at least 10 days of treatment, and they emphasise that baby needs to be treated as well.

It is a good thing I am 1. informed about this already and 2. bloody minded because this is very, very close to the last straw. Sorry, just needed to rant.

Am going to my BF support group tomorrow and will speak to the BFC, the midwife and HV and insist on proper, research based treatment. But at the moment I am so tempted to pack it in. Argh.

You poor thing
Is it too late to call the hospital? Why did the HV not give you a prescription for the baby as well?

By "too late" I mean at 9 weeks - I know you can call for a while after birth

you just need daktarin oral gel for the baby - you can buy it over the counter

Hi Stealth
I actually delivered elsewhere from my local hospital and hope to get to the bottom of it tomorrow at the support group-thank god it's on tomorrow!

Just can't believe the shit advice that gets spouted out there and sooo wanted to start treating us both.

And why my HV didn't organise treatment for baby I have NO idea...

Thanks EldonAve I didn't know you could buy it over the counter- I will if I don't get a script for it tomorrow. x

eldonave... daktarin gel is no longer recommended for tiny babies due to choking risk.

the OP needs a prescription for nystatin liquid.

and actually the one off fluconazole should NOT have been prescribed for nipple thrush without a GP seeing the OP. and as OP quite rightly says you need a longer course of it

mamacita... get an appt with a GP.

fluconazole is not licensed for breastfeeding mothers yet. however you can get it on prescription but your GP needs to know that you know this and have chatted with you about it first.
(trust me, btdt got the t-shirt, several times! lol)
they should not be giving prescriptions out for it without seeing you.

so you need
1.) a script for a longer dose of fluconazole
2.) a script for nystatin for baby

but you really need to see a GP

thisisyesterday - point about the daktarin duly noted, does this mean a GP won't give it anymore? the nystatin stuff is vile

nope, GP won't prescribe it for a baby under 4 months i believe

that said, I did use it for ds2 when he was about 8 weeks old and found it much, much easier to use than the nystatin. with the added benefit that you can use it on your nipples too.

but that was about ooh, a week before the new guidelines came in.

so, one for you to judge! lol

nystatin is the first treatment for babies but if the thrush is immune as is often the case now, some gps will prescribe daktarin gel - well mine did with a letter from lactation consultant when A was 10 weeks.

getting enough flucanazole was harder but lc gave me a new paper assuring me new reasearch shows i wasn't at risk of liver failure from it...

I am using the daktarin oral gel on DS2 (4 weeks) - I have read the BFN press release and understand the risk of choking so I apply very carefully. DS1 was prescribed it at 2 weeks so I feel confident that it is ok for us.

I hope the thrush clears quickly, I know it is hellish Are you taking acidophilus, washing bras at 60 and changing every day etc? It really makes a difference.

There's a lot of confusion around about meds for thrush. If you have only (!) nipple thrush then only the surface of the nipple and baby's mouth need treating. this would be with miconozole cream for your nipples (not the gel, this is poorly absorbed on the nipple) and either gel or drops as discussed in the thread for baby's mouth. Fluconazole is appropriate where there are symptoms of breast thrush and where positioning and attachment has been recently reviewed by someone well trained in breastfeeding. The main symptom of breast thrush is stabbing pains after a feed, but similar sensations can be caused by referred nerve pain from poor positioning (latch), hence the need for this to be reviewed first, even if p&a was previously good. If it's breast thrush then it's fluconazole, cream and drops/gel.

Good luck!

Many thanks everyone- I have now been given a whole gamut of drugs and have ongoing fluconazole, Daktarin cream for nips and Nystan oral suspension for the little guy. ProvincialLady bras are in the wash as I type and I will get a friend who is visiting from the city this weekend to get me some acidophilus- I live out in the sticks so no such fancy pants stuff out here!

Thanks again everyone x