Cannot get rid of babies oral thrush!

[SummerSun24]

As it says on the tin, had it about 6 weeks now and on 4th round if Nystatin. It seems to keep it at bay but never completely clears it.

Baby is EBF so I have been sanitising nipples with a skin spray, applying daktarin gel (although probably not as religiously as I should). Both on probiotics as well.

Any other tips would be massively appreciated, doctors don't seem interested as the Nystatin does help to reduce it. The miconazole gel isn't available anywhere either but I have heard this is better.

Just at my whits end on constant cycle of applying the medicine and baby seems to be having pain in their mouth when the medicine runs out and we then have to wait for more (national shortage of that as well apparently at the moment!!!). Any advice would be massively appreciated 🙏🏻

How old is your baby? Wondering if moving away from EBF would help. Weening or boiled water for example.

Baby is 12 weeks old. I am not willing to stop breastfeeding when personally I feel there should be a way to treat the illness in this day and age 😂 but I understand where you are coming from!

Ignore the poster who says to stop feeding or just give water 🙄 can you ask to see another GP? If it's that hard to clear is there another infection going on that's weakening their immune system and making them more susceptible?

@Springadorable I am looking to go back to doctors next week as I'm worried as well there might be something else going on! They have so far never swabbed either to confirm what it is. The treatment has been shocking to be honest. I wasn't even told how to properly use the medicine to begin with 😫

That is awful. Definitely go back and see someone else if you can. I'd want to ask:

Why the prescribed course isn't clearing the infection in the normal time
Why it keeps coming back
Could this signal something else is going on too
What other courses of action are available

And if they try and dismiss you as being a neurotic mum I'd ask if they are 100% confident that there's nothing else that can be done and that they can be totally sure there are no other issues, because if they have any doubt at all you want a second opinion.

At 12 weeks baby can use miconazole gel which is more effective and miconazole gel won't work on your nipples. https://www.breastfeedingnetwork.org.uk/factsheet/miconazole/

@Bert2e I was initially prescribed this but it not available in pharmacies or online!!

Is it actually thrush? As in present on gums and mucous membranes not just the tongue? I’ve seen a lot of babies recently with weeks of thrush treatment with white tongues. No thrush just oral motor skills issues .

@TheDisillusionedAnarchist yes it's all over the mouth, gums, cheeks, lips

Keep hunting for the miconazole gel - try ringing round independent pharmacies, they're sometimes more resourceful, or you may get lucky with somewhere small happening to have one left.

Are you having any pain, especially deep pain? You might need a course of oral antifungal tablets.

Miconazole gel has been unavailable for more than a year now as far as I know. Nystatin is just out. Might be worth asking GP for a systemic treatment?

Chat GPT tells me if oral thrush is persistent despite topical treatment, oral fluconazole can be prescribed

Are you sure it is oral thrush? Only because my daughter was needlessly treated for this for weeks, even going to hospital about it and in fact she never had thrush- she had milk pooling on her tongue from a severe tongue tie only picked up by a lactation consultant (we hadn’t had issues with feeding due to my oversupply).

miconazole gel has now been discontinued also. Your doctors surgery will be able to swab to check for thrush too

A private consultant I saw said the only thing left to do after the nystatin was gentian violet (a very old treatment) if needed after we had tried probiotics as well.

Thanks for all the replies. I will be going back to the doctor's for some support and will keep looking for the gel. I had heard about gentian violet @Sophie3003 but saw mixed reviews on wether or not it was ok for babies, but I am really willing to try what I can at the moment.

What are you doing steriliser wise?

I exclusively breastfeed @princesspadam so I have bought a skin friendly sanitising spray I use on my nipples after each feed. I used breast pads that I change regularly but that's about it. Baby actually sucks on hands to sooth while going to sleep so that's another challenge

we had to have the anti fungal tablets as I was also getting the deep breast pain in the end along with the nystatin. The other thing that was suggested was to put my bras and breast pads on a 60 degree wash. It cleared up after all these things when I didn’t think it would ever clear up. Not sure if the washing actually helped but worth a try at this point?

Sorry I thought I read EBM

Is your baby sensitive to something you are eating and passing on through breasr milk. Might be worth looking at your diet.

I would think very carefully before using gentian violet, I wouldn't handle it in the laboratory without gloves on :/

https://www.ncbi.nlm.nih.gov/books/NBK501869/

Free link here to a reliable source discussing the problems GV can cause your baby's mouth and gums.

Oh meant to add it doesn't seem like I have it at all, I have no pain / irritation on my nipples but have been treating myself regardless.

Will make sure I'm washing on 60 than you @HardySnail . I may ask about the tablets too just for something else to throw at it

This. I had severe thrush in my breasts when feeding ds. Nystatin didn't help, and I was in a lot of pain. DS was miserable too.

In the end, a double course of Fluconazole was the only thing that worked. Plus boil wash everything.