Celebrating brilliant health professionals.

[Tambajam]

I am a bf counsellor in London and would like to take a moment to say Three cheers for Dr Doris Blass, a GP in Hornsey, North London.

I met a mum who went to her with symptoms of ductal thrush. Dr Blass identified the problem, wrote a prescription for fluconazole after chatting about why it isn't licensed, gave something for the baby, gave the mum a copy of the breastfeeding network thrush leaflet, observed a feed and recommended a visit to a drop-in.

I KNOW this should all be standard of course but I am sooooo bloody sick of hearing GPs who aren't informed about breastfeeding and thrush, think thrush is the disease of the paranoid middle class, aren't prepared to prescribe fluconazole and undermine bfing at every turn.

So I wanted to say Yaaaaaaay when I heard of a good one.

Thank you!

Thanks for your post Tambajam.

I am a GP but the full extent of my knowledge about breastfeeding has come through feeding my 2 kids and reading things like kellymom.
I think I am in a position to give good advice and would always consult a counsellor or check-up on things if I was not sure. I wonder if there is a way to promote breastfeeding knowledge to practicing GPs as I too have heard some really bad advice being given out (in good faith, I am sure).

Have you given Dr Blass some feedback directly - I am sure it would make her day!

Hmmm.

Ductal thrush may, however, not exist - there are expert people who are far from convinced of it.

I agree with you about GPs undermining bf, which some of them may do.

Nice to hear good things. One of the Mums on my caseload recently went to her GP because her baby was vomiting after feeds. Her GP's advice:

"Hmm. Well obviously your milk doesn't agree with him so put him on formula"!

do encourage the mum to give Dr Blass some feedback.that is always appreciated

nice story

Chewy toffee - I sent her a little note.

Tiktok - Are you in the group who feel it doesn't present in the ducts then?
I struggle with that having worked with mums who have nipple symptoms, a thrush history, recently finished antibiotics, and the ductal pain becomes excrutiating and is alleviated by fluconazole. It seems logical that as antibiotics use increases we would be seeing more thrush. Why would it not enter the ducts? Sounds like the ideal environment for thrush. I agree ductal thrush is often misdiagnosed however. I met a mother on the second round of fluconazole 'with no effect' who had letdown pains.

A good and heartening story, on the same day as my HV said "you need to start weaning him as it's clear YOU (my emphasis but her wording) are not enough for him" when I told her about my 21 week old feeding like a demon at the minute. SIGH.

I had my booking in appointment last week.

The midwife asked if I had breastfed ds who is almost 4.

I replied that he was still breastfeeding to which she replied that she thought it was brilliant and well done.

A far cry from what I was expecting which was that I should instantly wean him.

Hooray for the midwife.

What about a medical professionals' journal devoted to bfing? What about some professional conferences? Research? How about forming a group and hiring a professional pr firm? I'm not a medical professional, "just" a mum(of 5) who has had enough conflicting advice from the profession to fill quite a long and hilarious book.

I went to see the HV about my then-5mo non-sleeping dd
HV: How are you feeding her?
Me: She's exclusively breastfed
HV: [smiles] Oh well, we won't mess with that then

Tambajam - I don't have a view, really, on whether thrush in the ducts exists. I am just aware that it has never actually been discovered there, its presence is inferred rather than observed, it is difficult to test for.

I have supported mothers whose persistent pain has indeed been improved with the usual treatment for ductal thrush but that 'proves' nothing at all. I have also supported mothers whose persistent pain was no different after this treatment. And mothers who have been told 'it's thrush' where a change of the way they attach the baby seems to help a lot.

There are people far more aware of physiology and pathology than me who think it's highly unlikely that ductal thrush is a problem or even a possibility