UPDATE...Aw heck...we've got thrush...need advice...warning LONG

[Dyonia]

Hello everyone, its time for me to de-lurk b/c I need your help and advice... I'll introduce myself briefly:

I tried de-lurking back when Neve started that big thread, but my post didn't "take". I know the problem has since been rectified, but I never got around to redoing it (go figure, giving birth and becoming a mommy got in the way...hehe) My name is Donna, I'm 26, a mostly SAHM. DD was born on 2/22/04, so she'll be 3 months next week. DH is 28 and a network engineer. We're from the Phoenix area, and still new to the Valley, so hi to all the other parents out there.

Okay, on to the problem -- we've been officially diagnosed with thrush. DD and I are visiting my family in rural MD, so we don't even have the benefit of seeing my OB or family doc for more help (and poor daddy is back home, so he can't help either). DD is on the Nystatin oral suspension at 2 ml 4x a day, and I am on the nipple cream 4x a day also. Are these instructions appropriate? I keep reading elsewhere that both of us need to have the Nystation reapplied after each feeding.

After doing some reading on KellyMom.com, searching on here and a few other BF-friendly websites, I am throughly confused as to whether we should even bother continuing with the Nystatin since it doesn't seem to be a very successful treatment. I *think* she is responding to it, b/c she is nursing better, seems to be less gassy, and is behaving more like herself.

The ped we saw here doesn't believe its necessary for me to be treated other than with the nipple cream. I'm pretty well convinced that I need to be treated so we don't pass it back and forth. I also believe we've had this since she was born b/c I was induced and was also on pencillin during delivery. That's the part that makes me think its very likely in my ducts (I have had sporadic deep breast pain, but more often they itch inside -- make any sense?) What can I do to treat myself? Call my OB and ask for a prescription for something? Can I treat myself with Grapefruit Seed Extract? (If so, how? I've seen two different treatment regimines with the capsules...)

The big question is do I continue on with the Nystatin and hope for the best? Do I supplement with Grapefruit Seed Extract (GSE)? Should I switch over to GSE or Gentian Violet for DD? Should I just treat mystelf with GSE? I did insist on the ped giving her a dose of Gentian Violet at the offce, though he insisted that I did not need to do Gentian Violet as the course of treatment. Oh heck, I nearly forgot to as about acidophilus/bifidus capsules -- where do I find those, and what kind of dosage do we need?

Ugh....I'm not sure how much sense I'm making here. Other than the thrush, we've had a pretty successful breastfeeding relationship, and I really really want to make it to a year. Please help me beat this -- I really don't want to have a recurring battle with thrush! What else do I need to know to beat this? The ped didn't give me any other advice. (I've boiled the pacifiers and bleached her burp cloths btw.)

If you made it this far, THANK YOU !!!
--Donna


UPDATE:

Dear everyone -- THANK YOU so much for yourgood advice and kind words of encouragement. I'm now on Diflucan - six days after DD was diagnosed. I'm taking Grapefruit Seed extract and Bidifophilus capsules (also giving DD some). She is still on the Nystatin suspension, except I'm giving her 1 ml. after each feeding -- approx. avery 3 hours. This way she gets it more often, and still gets the total daily 8 ml. dosage. She seems to be responding to it b/c she is nursing better and the white patches inside her mouth are gone... but of course we won't know for certain for some time

My biggest problem has been trying to find the GSE and Bidfophilus in thie little town in the middle of nowhere...There is no organic store within an hour! Let me put it this way... the biggest place to shop around here is Wal-mart. But on the bright side, at least I'm here where my mom can help me and I don't have to deal with my MIL :-D hehehe....

I've been washing my bras daily and using vinegar in all our laundry. I've also been using a vinegar rinse on my nipples and on her bottom. i've taken to wiping down her face, neck, and hands with the vinegar solution as well b/c she loves to chew on her hands and rub them on her face. I should just buy stock in paper towels and vinegar companies after all this!

My LC is confident that we will beat this! I thank all of you for your help -- this board rocks!

--Donna

[RDHmommy]

I am curious to see the replies also as I have the exact same problem. My baby is now on Diflucan after taking the Nystatin oral suspension for 2 weeks with no results. I have been using the cream also and not had any relief myself. We see the pediatrician next week. I just want us to be rid of this.

BTW, besides the obvious (white patches in mouth) do you know what other symptoms/effects thrush has on baby? Does it cause more gas? My baby has been running a low grade fever on and off, been more fussy, and had more gas. Just wondering if these were related to the thrush.

I was induced also and ended up with a severe vaginal yeast infection after delivery. So it made sense that baby ended up with thrush and passed it back to me.

Good luck and I hope we get some answers soon!!!

[heidi_timms]

I used Nystatin for weeks without success. Acidophillus with Bifidus or just acidophillus tablets did the trick. I bought them at whole foods markets or any natural food store in the refridgerated supplements section. Mine were chewable banana flavored. I also crushed up a chewable tablet, dipped my finger in water, and dipped in the powder for the baby to eat off of my finger once or twice daily. I also ate lots of yogurt with acidophillus-yoplait! After weeks of Nystatin, the thrush was gone in 3-5 days with the acidophillus.

Other than that I'm sure they have told you to boil bottles, nipples, etc. I also would clean my nipples with white vinegar after feedings to kill bacteria. Also, change and wash bras often and breast pads. I didn't boil my bras, but washed in hot and added a little bit of white vinegar (1/4 cup) to each load. It doesn't make your clothes smell, trust me!

I've also heard gentian violet works, but stains badly and is messy. I didn't use because my DD used to spit up a lot and we would have had purple everywhere!

Hope you and baby feel better soon!


~Heidi
Mom to Kailey Ashlin
4/27/03

[chlobo]

About the acidopholus - my ped. told me that a study was recently done that showed the capsule form to be more effective. I guess more of the acidopholud made it to where it needed to go than when compared the tablets.

Just a thought for when you buy the acidopholus. I also got my capsules in a refrigerated case at whole foods.

[Rachels]

I've never heard of anybody who was actually helped by Nystatin. We sure weren't. Nystatin, among other things, has sugar in it, which yeast feeds on. Acidophilus is definitely helpful. Many moms here have also found that the only thing that really does fix it is Diflucan, at least a 14-day course for both mom and baby. If the yeast has gotten into your breast ducts, something topical won't be adequate, no matter what.

-Rachel
Mom to Abigail Rose
5/18/02

[heidi_timms]

Some drs won't prescribe Diflucan. I begged, but no cigar. I just wanted to be better, but I guess they must be extra cautious!

~Heidi
Mom to Kailey Ashlin
4/27/03

[smallestangel]

Oh, I know how you feel! :( We had thrush for around two months. I was on antibiotics during delivery too and think that's why we developed it as well.

Here's another bad vote for the nystantin. It didn't do anything but make Jacob gassy and colicky. I also had a two week course of Diflucan, I saw relief for three days and then it came charging back.

What finally worked was gentian violet and a nipple ointment that my LC recommended but I needed my doctor to prescribe. We used the gv for four days and the ointment as needed. The gentian violet really wasn't as messy as I had read it would be. You don't need to use that much. Yes, Jacob's lips and my nipples were purple for a few days but it wasn't a big deal and it was worth it!

We also washed everything (towels, sheets, etc..) in hot water and vinegar after one use. I also boiled my bras and breast pads. I was constantly doing laundry and it was a pain but yeast is very persistant! We used paper towels after washing our hands instead of a towel. I also used a vinegar rinse on my nipples. And I went braless as much as I could too. I also cut out sugar from my diet as much as possible.

Here's a link to the gentian violet and nipple oinment usage my LC gave me:

http://www.breastfeedingonline.com/candidaprotocol.html


I hope some of this helps. It's good that you're posting here. Everyone is really nice and a great source of information, advice and support. :)


Amanda & Jacob (born 3/11/04) :)

[houseof3boys]

I had a few battles with thrush and IMO you need to be treated more aggressively. My ob gave me a cycle of difflucan one every other day for a week on two occasions and it didn't work effectively enought to get rid of it. Right when I thought I was better, the prescription would be finished and then I had the pain 2 days later. Some strains are very difficult to get rid of and need to be treated more aggressively according to the LC I went to see when I had it. In the end, I had to go to a dermatologist to get the appropriate treatment since my battle with my ob was pointless on current treatment. I would recommend calling an LC for advice and maybe she can call your doctor in regards to the latest protocol. For me, that was 3 solid weeks of difflucan to get rid of it and it hasn't been back!

I don't know about the GSE knocking out the thrush either. I took it everyday for 8 months and now take it when I remember. It is horrid tasting, btw!!! It certainly won't hurt but I don't know if it is strong enough to rid it, but I do think it will help keep it away.

The Gentian Violet never worked for us and as Heidi said, it stains horribly. Ryan had purple lips for days and that was with dilligent vaseline and lansinoh application to "protect" them!

It really depends on how long you have had it and how affected you are, meaning is it in the ducts? Do you have deep pain more than you don't, since you said it was sporadic? I never really had itching but I had deep throbbing pain that lasted for 30 mintues after every nursing session. It brings tears to your eyes to nurse through the pain sometimes, I remember.

I boiled everything and was a nut for paper towels instead of washcloths or burp cloths. Don't have any sugar or yeast products until it gets better either (or at least reduce the amount). Sorry for the next one, but since it's getting so hot out....change your bra if you get sweaty! That is a breeding ground for yeast to multiply.

I hope you get treated soon and start to feel better. Keep breastfeeding and before you know it, the thrush will be gone! :)

[Rachels]

I battled that, too. I say find a different doc if need be. Few are really educated about bf stuff, and my view is that you and your babe shouldn't have to suffer for their lack of bf knowledge.

-Rachel
Mom to Abigail Rose
5/18/02

[Rachels]

I've used APNO too! Good stuff.

-Rachel
Mom to Abigail Rose
5/18/02

[parkersmama]

I've had pretty good luck with GV in the past but the most recent bout of thrush, I had to do Diflucan. It did knock it out quickly, though.

My LC told me to also try the OTC yeast creams as topical treatment for my nipples (wash off before nursing). White vinegar rinse was also recommended. Sun is great, too! Put your bras out in the sun and if you have a way to do it privately, expose your breasts to a bit of sun each day (being careful not to overexpose...sunburned nipples?! ouch!). Also, my LC said do not use washable breast pads while battling thrush. Get a disposable brand that does not have a plastic backing (traps moisture and allows yeast to breed). I was using ones by Medela and she said those are the ones they usually recommend.

Hope you're able to get rid of it quickly!

[lynettefrancois]

Nystatin works for less than half of patients. Call your OB and ask for a recommendation for another ped, and go see a Lactation Consultant nurse right away. I can't believe your ped thinks you only need nipple cream. I spent over 2 months and well over $500 getting rid of the thrush, mostly because the ped wouldn't prescribe anything stronger than nystatin for DD. We tried everything you mentioned, some at the same time, and finally switched peds to get a prescription for diflucan for DD (I had already been on it a month, prescribed by my ob, with no success). I'm not saying you need diflucan, but you need a much more aggressive treatment. Most doctors are WAY behind in information about it, including the new stronger strains and needed doses. Keep doing what you are doing (it may keep it from getting worse) until you can see someone that knows what they are talking about. Keep looking at those websites. Here's what I would do in your shoes:
1. Sleep on a towel, change daily
2. Bleach everything, vinegar rinse
3. Buy medela steam cleaning bags and sterilize all paci's daily
4. Buy GSE and refridgerated Acidophilis capsules for you
5. Buy Right Start by Natren bifidus powder for baby (I believe the dose is 1/4 tsp per day, but call the company (800# on bottle) to double check
6. Use the GV for 4 days
7. Cotton only shirts, no bra if possible, cotton bra if you can't go without and definitely no breast pads! Keep a supply of shirts so you can change often.

You'll have to call around to health food stores to find all those supplements.

http://www.breastfeedingonline.com/candidaprotocol.html

That link is Jack Newman's candida protocol, the most recognized expert in the field. This is what the Lactation Consultant nurse printed for me to take up to the OB. Finally got me an APPROPRIATE diflucan dosage. HTH!

[houseof3boys]

Let me know if you want me to get some liquid GSE and mail it to you! Here is a site that has the one I use: http://www.herbalremedies.com/gseliqcon2oz.html

I think I paid a few dollars more at Whole Foods for mine so it might work out the same with shipping.

Glad to hear you are on the road to recovery. Hang in there Donna! :)

[lynettefrancois]

>white patches inside her mouth are gone... but of course we
>won't know for certain for some time

Donna- ask your LC how long should it be before there are no symptoms for you- the white patches disappeared from my DD with Nystatin, but she still had it (many medical professionals incorrectly think there must be white patches to have an infection). She passed it back to me, so we ended up putting her on diflucan also. Not saying this is what you should do, just ask the LC how long it should take for YOUR symptoms to disappear. Also, ask about Newmans All Purpose Nipple Ointment. Here's the ingredients:
http://www.kellymom.com/newman/treatments_sore_nipples_breasts_01-03.html
It helped SO MUCH more than anything else (nystatin cream did nothing, and I also tried monistat cream and Lotrimin AF, but none did as well as this). It's not cheap if your insurance won't pay but worth it IMHO. It has to be "compounded" and lots of insurance companies won't pay for compounding (the bastards).
Glad you are doing better and on the road to recovery! Good luck and keep us posted! :)