Argh - mastitis,thrush,cracked nipple,mastitis,thrush.......

[Alibear1]

I had a bout of mastitis in November which I took ABs for, wondered at the time if it had given me thrush in my nipples but thought it would settle down.
Before Christmas I got cracked and bleeding nipples, and got another bout of mastitis over Christmas which I took ABs for, and now I'm 99.9% positive that I've got breast thrush. Pain during a feed that worsens after the feed, and now ANOTHER cracked and bleeding nipple.
I've woken up this morning with that dreadful ache and the telltale red lines/blotches.

I'm desperate not to take another course of ABs because I just feel that they are making the thrush worse which seems to be the cause of the mastitis. Has anyone successfully self-treated mastitis?

I'm going to go to the Drs and ask for treatment for the thrush, armed with the BFN leaflet incase they think I'm lying/over-reacting.

Any tips gratefully received, at my wits end

alibear how old is your baby? have you seen a bfc to double check latch and positioning??
bad positioning or problems with latch can cause pain and cracked nipples very similar to the symptoms of thrush.
so it's definitely worth making sure you're being scrupulous about both before treating for thrush

I had recurrent mastitis until DD was five months, but only took ABs the first time (then ended up in the thrush cycle you're describing so decided not to take them again if I could at all avoid it). What worked for me was to express underwater in a hot bath from the affected breast as soon as I noticed another bout beginning; this cleared it quicker. And if it's at all possible, go to bed, take painkillers (you can alternate paracetamol and ibuprofen if you need to).

DD was in fact tongue-tied; because she was gaining weight fine nobody picked up on it until she was 9wks and it wasn't corrected until 12wks, by which time she'd got into a lot of bad feeding habits which caused me a lot of pain, including pains worsening after feeding. This continued after I'd treated the thrush and wasn't in fact a symptom of the thrush but of the way my nerve endings were being crushed repeatedly. Has anyone checked you LO for tongue tie? I know it's a horrible idea but in fact the procedure to correct it is tiny and fine, less traumatic than her vacs in fact!

I hope it does work out for you - if it helps, when DD was 8wks I'd decided I couldn't possible BF any longer and was going to stop altogether if something hadn't changed within a fortnight. In the end I exclusively BF for six months and now at 12mths DD is still having a morning and bedtime feed.

And can I also second what thisisyesterday says - thrush is very difficult to diagnose, I'm still not sure it's what I had and even though I managed to get a GP (eventually) to prescribe me flucanozole that didn't solve the problem. But discovering and dealing with DD's tongue tie and resulting bad latch did.

I have no advice but would like to bow down to your strength! Had mastitis with dd and I have never known a pain like it - I remember telling dh even labour wasn't as bad as it didn't last for as long LOL

thanks for the replies

TIY - I've had my latch checked and all is well, strangely the actual feeds haven't been hurting too much in terms of the nipples, it's deeper into the breast and then after the feed.

Fleacircus - we had DS checked for tongue-tie when he was born as it runs in DH's family and he's fine.

I didn't manage to get an appointment today, hopefully I can get on the emergency surgery tomorrow. Had a chat with the BFC at the hospital who helped us when DS was tiny, she agrees that I probably need the fluconazole and has suggested asking the GP to prescribe alongside some ABs to knock the whole thing on the head. Had awful fluey symptoms earlier, just shivered for hours so I think I'm going to have to take some ABs - right nork is sooo red, a mass of blotches and lines. Fortunately DH is able to work at home tomorrow to help me out, the worst thing is not being able to really carry DS because my underarm/nork/side is so painful.

Alibear, sounds horrible

Are you expressing? I have been getting recurrent bouts of mastitis as well and have pinpointed it to DS's bad latch made worse by a pump that isn't draining properly. I've managed to clear it each time without recourse to ABs though by massaging and frequent feeding and hand expressing. Having been in the thrush cycle for nearly six months with DD I'm loathe to go there again!

The pump caused me problems when I was feeding my DD as well and the recurrent blockages and mastitis stopped when I stopped expressing.

there is great advice on kellymom

alibear might be worth taking some probiotics and stuff if you're having ab's as well. you don't want to end up with another bout of thrush straight after! lol

hope it all works and you're feeling better soon though

thanks everyone

Update today is that I went to see the GP this morning, and she was lovely! Turns out that she is very pro-BF having struggled and succeeded with her own kids, and has done lots of research etc into reasons why mothers stop BFing etc.

Anyway, she's prescribed me fluconazole and a course of ABs to take alongside and made me an appointment to go back and see her again next week. She checked DS over, mouth and bum, and said that he's not infected and that the little dose he'll get through my breastmilk will be enough to prevent it from crossing to him.
She's also recommended that I limit sugar if possible.

So, hopefully this will get it all sorted out. My bras are all on a hot wash now and I've stocked up on breastpads.

LackaDaisycal it's bizarre but I have no blockages, the infection seems to have entered via the cracked nipple rather than as a result of a blocked duct (which I've had before and cleared as you describe), so I've not been pumping. I don't really want to encourage extra supply and risk engorgement on top of it all....

TIY that is a good idea on the probiotics, I guess it will all help!

glad you have a lovely sympathetic GP Alibear and I hope things clear up quickly for you....fair enough on the expressing if there is no blockage.

someone suggested the pro-biotics, might be worth taking alongside the ABs. another good natural remedy is green bush flower essence. I took this and gave some to my DD and managed to chase off the worsening of thrush. I now take it as soon as I feel the familiar dull ache and it seems to be doing the trick.

Good Luck

Is she saying that the fluconazole in your milk will prevent your baby getting thrush? I'm sorry to tell you this, but this is not right. The dose that gets into the milk is insufficient to treat thrush in the baby, and it's recommended that both the surface of your nipples (miconazole gream -daktarin) and your baby's mouth (nystatin drops or miconozole cream) are treated as well. The BfN leaflet states:

"When using oral treatment it is still important to continue to apply cream to the nipples after every feed, and to treat the baby's mouth four times daily"

Daktarin and miconazole oral gel are both available over the counter. Nystatin's on prescription. There are issues around the use of miconazole oral gel, that are explained here.

Does the course of fluconazole last longer than the course of antibiotics? Often GPs prescibe a lower dose than the BfN leaflet suggests and for less than the minimum 10 days recommended. As long as you're on ABs then the risk of thrush is higher, so the risk of the thrush recurring might be less if the thrush treatment extends longer than the ABs.

Hope it all heals up soon.

Please excuse the typos , it's late.

Grendle that does seem to be what she's saying, because DS is clear of thrush she doesn't feel he needs it.
The ABs last for a week and I have a 10-day course of fluconazole which started with a loading dose on day one, so I'll have 3 days more of the fluconazole after I've finished the ABs

The pain does seem to be decreasing already, no pain at all after DS fed from the problem side this morning so fingers crossed it's working.

Bear in mind Ali that it can sometimes take a further course of fluconazole to clear it completely. If you still have any residual pain after this course is finished, get yourself back to her quickly.

My last two bouts of thrush have taken two courses.

I'm glad you're feeling better though

Lacka I have a follow up on Friday booked in already so if things aren't knocked on the head by then I shall be asking to go back again once the fluconazole finishes on Monday to get more. I don't do pain very well

oh good

It's a horrible horrible pain.

I'm glad the pain's increasing Ali. If you do go back to your GP, you might want to consider taking the BfN leaflet (the section for health professionals) with you. It's very clear that both mum and baby need treatment, even if baby is asymptomatic. The link is in my first post. It would be awful to clear it only to be re-infected once you stop treatment.

decreasing obviously not increasing, sheesh, sorry brain clearly not functioning

Alibear poor you! I had problems with possible thrush, mastitis, excrutiating pain and general breastfeeding misery early on which didn't seem to respond to fluconazole treatment as per BFN leaflet. I took grapefruit seed extract tablets as described in La Leche thrush info pamphlet and recommended here on MN. Never had any problems since, can't be sure it was the GSE but would recommend giving it a go. I found ibuprofen really helpful for the mastitis too, I suppose it's the anti inflammatory properties, thankfully never had to resort to antibiotics, a couple of days of top dose of ibuprofen always seemed to get it under control. Hope you're feeling better v soon