So confused...Please help

[s_gosney]

Hi everyone. I have a serious case of he says she says going on and I don't know who to trust. DD is 9 days old and she had a bacterial infection at birth, so we've only recently completed a round of antibiotics. When the home health nurse was here two nights ago giving her the last of the shots, she told me to watch her mouth for any signs of thrush because as the antibiotics had killed off both good and bad bacteria, she would be more succeptible to yeast. Makes sense to me--women are more succeptible to yeast infections when on antibiotics--so I make a mental note to check for white stuff in her mouth. Then Wed. we go to the ped for a follow up visit to make sure she's doing well following the antibiotics and I bring up the issue of thrush, mostly to ask how long I need to be watching for it. He looks in her mouth, says he doesn't see anything and that she's no more likely to get it than any other newborn. Huh? So who's right? He also said that most likely I would notice sore nipples first and now I'm scared at every little twinge. I definitely have some nipple pain, but isn't this typical of the first couple weeks of bf? As far as I can tell, DD is still latching on good and the pain is only intense for the first few seconds while she's getting settled in and then diminishes to almost nothing for the rest of the feeding. No cracking or bleeding, but all of those stories I've heard from others make me tend to just write off the pain as getting broken in, kind of like the whole sore fingers from learning to play guitar thing.
The home health nurse is also the LC at our hospital and I tend to trust her, but I hate to think that I can't trust my ped. He also mentioned some other stuff I don't agree with like offering "good service" to the baby during the day and "slow service" at night so she'll learn to cluster her feedings during the day and sleep more at night. Now maybe I'm crazy, but I think a week old is a little early to start this sort of thing. As far as I'm concerned, the routine of feedings at midnight, 3, and 6 (approximate, and on demand of course) that she's established for herself is just great for such a young baby. Should I think about changing peds already?
I sure hope this stuff gets easier. I'm so glad all of you are here to answer questions.
Sorry this got so long and Thanks for all the help!

[barbarhow]

I would have to agree that one week old is way to early to begin to try and "train" an infant into a feeding schedule. On demand is certainly the way to go. An infant is incapable of being manipulative and needs to feed when she needs to feed.
Sore nipples early on are definately normal. If the pain only last for the first few sucks it is probably normal breaking in your nipples pain. It is when the pain last throughout the entire nursing session, is excruciating in nature- that one would think about yeast. With my yeast infections I had shooting searing pain that went deep down into my breasts and radiated-stabbing like up to my arm pits. There was definately a difference between the two pains.
HTH
Edited to add-I am deferring on your first question because I am uncertain. It may be that the type of antibiotics that she is on doesn't affect mouth flora and thus wouldn't leave her more susceptible towards thrush but I do not know and defer to some of other moms.
Barbara-mom to Jack 3/27/03

[sntm]

I'm not a pediatrician, but I am a doctor and I would agree with your HH nurse. I also agree that you should be very responsive to your baby at all hours, especially at this young age! A 9 day old is physically incapable of going all night without eating (and it would be unhealthy for her to do so) and she developmentally is incapable of manipulating you.

edited to add: sorry, above was a little unclear. mean i agree with the HH nurse that antibiotics increase your susceptibility to fungal infections


shannon
not-even-pregnant-yet-overachiever
trying-to-conceive :)
PREGNANT! EDD 6/9/03
mama to Jack 6/6/03

[Rachels]

Your ped is definitely wrong about the scheduled feeding! YIKES. And our ped has said that antibiotics can make a baby susceptible to thrush, and the two times we've had it have been after antibiotics. So...

The thing is, you need to feel comfortable and to trust your ped. If you think you're getting bad advice out of the chute, then it might be worth switching. I did that. I knew when my first ped's advice made me squirm at three weeks that we weren't likely to agree later, either. Finding a new ped was stressful for the moment, but SO worth it. I love our current doctor, and I'm so glad we switched.

-Rachel
Mom to Abigail Rose
5/18/02

[KGoes]

Antibiotics do make you more susceptible to thrush. DD and I were both an antibiotics after her birth and both had thrush, although I developed symptoms way way before she did. The pain that I had was a burning sensation with the added sensation of needles being stuck into my nipples. The burning sensation tipped off the LC who sent me to my OB.
I also second the advice to feed on demand. Babies at that age only know that they are hungry - they have not read all of the books that say they should only be hungry every three hours! Write down when you feed her and in a couple of weeks, you may realize that she is already on a schedule.
Finally, if you are not comfortable with your ped, I would change. My ped did not take thrush seriously since DD did not have symptoms. Not only is it common for the baby to not have symptoms, but my OB was treating me for thrush after an examination, so basically she was saying that she didn't trust her medical colleague's opinion. She also told me that something I was eating must be making my baby fussy (as though formula fed babies never cry) and I made myself crazy subtracting things from my diet. As it turns out, it was just a baby crying. In short, I would leave her office in tears of frustration. I finally switched peds after I started wondering what else she was not keeping up to date on and it made all the difference in the world.
Here's to hoping that you do NOT have thrush!!
Kelley
DD born 7/30/03

[peanut4us]

Honey, your ped, maybe not so good. Definately thrush is a possibility. My ped suggested that I take chewable acidophilous (sp??) tablets for the duration of antibiotics that Sara was taking... it's like a live culture thing... (tells you how much I understood). You buy them in the health section of the grocery store. I got strawberry flavored! Yummy! He said to continue taking them for 5-7 days after she was done with her antibiotics. In the last 7 months between the 2 of us, we've done antibiotics 3 times taking those supplements (just me) and we haven't had thrush. So you might want to consider that. Just one tablet morning and night.

Also, my ped said to feed her when she's hungry. In fact, she was such a sleepy baby and had jaundice, he wanted me to wake her to eat if she went 3 hours without eating... that was just until the jaundice was cleared up and she was latching better.

I just have a VERY pro-bfing Dr. And so, he's very knowledgable about bfing issues like Thrush etc... Hang in there. And if for some reason you decide to change peds, you might want to consider asking several of your lactation counselors in your area which doctors they recommend. Sara had lots of health trauma at the beginning and it never ceased to amaze me that every LC we dealt with at hospitals (even a hospital 40 minutes from us) knew my ped by reputation as a good Dr and very pro-bfing!

Good luck, hang in there!

[kwc]

Sherri, I am a pediatrician and agree with others and your HH nurse that thrush (and yeasty diaper rash) are defiinitely more likely to occur after/ during antibiotics. I am guessing that your baby got Ampicillin and Gentamycin and those would _definitely_ wipe out mouth flora... I am trying to interpret what your ped meant? There are some that think that brand-spanking new babies haven't really developed as much mouth flora yet so maybe the antibiotics wouldn't make as much difference now as to an older baby? I am remembering from my time in the NICU that we saw more thrush/ rash in the babies that were older though these kids were likely to have been on antibiotics later and longer (not controlled and purely anecdotal!!!). Not sure, but your instincts re: thrush and demand feeding are good. Others here have given you better advice on watching for thrush than I can.

If you don't get a better feeling from your ped, I would switch. Maybe not now while there is so much going on, but if you still have nagging feelings of doubt later, make the change. As a mom and a ped, trust is SO important... I don't necessarily think that you have to agree on everything but it is really important to feel comfortable with your provider.

Best of luck and enjoy your new one!

Karen

[s_gosney]

Okay...so the pain got worse today and started doing the radiating back towards my arp pit today so I called the LC. She said to get some lotrimin cream and rub on there after every feeding and to expect to see results in a few days. Is this what you all do? Is there anything else I should do? Thanks again. You guys are great!