Thrush :(

[DrSally]

Since DD is on antibiotics for ear infection, she's all yeasty. Started with a diaper rash and then today I got a sharp pain when she latched on--What was that? At first I wondered if she bit me, but then I figured it out that she must have yeast in her mouth and now I on my left breast. I don't see any white patches in her mouth, but I'm sure it's there. Frickin frackin colds. I guess I'm luckily that in 3 years of nursing, I've never had thrush, but then this is the first time any of my kids have had to be on antibiotics. I'll call on monday and I guess they'll prescribe some sort of antifungal med for her?

[tylersmama]

:hug: That sucks. I had it twice, and it was NO fun. I never actually called in about it, I tried gentian violet first, and it worked for us. Whatever you do, make sure that YOU get treatment, too, or you'll just keep passing it back and forth.

[DrSally]

I know. Do you think the ped will prescribe for me too, or will I have to go to my own doc?

[frgsnlzrds]

:hug: That sucks. I had it twice, and it was NO fun. I never actually called in about it, I tried gentian violet first, and it worked for us. Whatever you do, make sure that YOU get treatment, too, or you'll just keep passing it back and forth.

10 years ago, gentian violet was available over the counter. I don't know if it still is. DS had it and the ped. recommended it for me and something else for DS. He did NOT tell me that it was okay to nurse once I put it on me though (they call it "violet" for a reason!) so the first night I placed a frantic call to poison control while holding a screaming hungry baby. LOL. I was a new mom.... :D

Good luck!

[ThreeofUs]

Hugs, Sally. Sounds like you guys have been through the ringer. How are you holding up?

[Melbel]

NAK
So sorry to hear you are joining the thrush "club." It can be quite difficult to get rid of, so check out the resources on kellymom.

Thrush Resources
... more than you ever wanted to know about thrush
http://www.kellymom.com/bf/concerns/thrush/thrush-resources.html

Gentian violet was recently linked to cancer in an Australian study but has been around forever. Note the recommended concentration in Kellymom and call ahead to pharmacies if you plan to go that route b/c it can be hard to find.

My OB initially prescribed Diflucan and Jack Newman's All Purpose Nipple Ointment for me, the pediatrician prescribed Nystatin (often does not work b/c in a sugar solution which feeds yeast) then Diflucan for DD2.

Sterilize all bras, bottles, pacifiers, towels, etc. Strictly limit your sugar and carbs. Get probiotics for both you and DD. Fivelac probiotics have helped me to get control, but not eliminate, the thrush for us (almost 9 months and counting). HTH and good luck!

[srhs]

My DS was asymptomatic (no white spots), but I was sure we had thrush. So, I just called pedi and said, "He has thrush." They called in nystatin for his mouth.
It wasn't enough to beat it in me. We did the aggressive sterilizing and the Gentian Violet (which was behind the pharm counter at our Walgreens for ~$2.) I had a whole system to reduce the mess if you're interested.
I needed the Diflucan because ours had gone on for months. It took me a long time to get someone to prescribe it for me without white spots in baby's mouth. I did, however, also have the Rx for the APNO, and it has antifungal; that will help.
I like Dr. Newman's resources:
http://www.drjacknewman.com/help/Candida-Protocol.asp
I also read a lot online and took a ton of herbal stuff to reduce yeast--cranberry, garlic, Echinacea, probiotics, etc.
GL!

eta: The direct links for Newman's GV and Diflucan info in case helpful to anyone searching:
http://www.drjacknewman.com/help/Gentian%20Violet.asp
http://www.drjacknewman.com/help/Fluconozale.asp

[tylersmama]

Yeah, I had to call about 6 pharmacies to find one that had it. It is over-the-counter, but behind the counter. And OMG yes on the "violet". Poor DS got some funny looks and comments because his mouth was shocking purple! :p

Sally, I'm guessing you'll have to call your OB or PCP to get a rx for you. If you tell them that DC has been diagnosed, they may not need to actually *see* you. And from what I've heard, avoid Nystatin and push for diflucan instead.

[DrSally]

Thank you for the info! I've heard nystatin isn't that effective either (40%?). So, that's something I put on my nipple or ingest orally? Do I wash it off before feeding? I suppose they'll tell me when I call. Hopefully, I'll just be able to call my ob's office. It's a large office and I don't really have a relationship with any one doctor, even the one that delivered me. I have yet to find a PCP here.

I also found Dr. Newman's resources very informative. I already read the kellymom stuff and some stuff on Dr. SEars. Dr. Sear's website says to dry your bras in the sunlight and let your nipples get several min of sunlight exposure per day. OK, the front of our house faces south and we don't any windows east or west, so, that would mean I'd be flashing the neighbors and hanging my lingere (if you can call it that) to dry in the front window!

BTW, is it weird that it only hurts on one side? I assume if we both have it that it would be on both sides. Maybe it is, but it just doesn't hurt on the other side?

[DrSally]

Gentian violet was recently linked to cancer in an Australian study but has been around forever. Note the recommended concentration in Kellymom and call ahead to pharmacies if you plan to go that route b/c it can be hard to find.

My OB initially prescribed Diflucan and Jack Newman's All Purpose Nipple Ointment for me, the pediatrician prescribed Nystatin (often does not work b/c in a sugar solution which feeds yeast) then Diflucan for DD2.


I have heard that info on Gentian violet. So, it's hard to decide whether to go with that or a prescription antifungal, which I'm sure has it's own issues. So, did you take the diflucan orally and put the nipple cream on topically (of course)?

IF Nystantin has such a bad track record, why are people prescribing it instead of diflucan?

I do have some probiotics I bought for suspected milk allergy in DD, so I had it ready to go. DS and DD (both on amox), and now me, are taking it. I noticed DD's diarrhea isn't as bad after she's had some of the probiotics.

It's hard not to have my "the kids are in bed" icecream treat.

[srhs]

I've heard nystatin isn't that effective either (40%?). So, that's something I put on my nipple or ingest orally? Do I wash it off before feeding?
I only know of oral nystatin for baby, not for you...you swab inside the mouth. It's also available in a cream for diaper rash when it's yeast. (They may make it for the nipples; I just don't know of it.) It is a topical liquid or ointment treatment whereas Diflucan is a systemic medicine. My pedi said they don't like to give Diflucan to babes because it's hard on the liver.

I suppose they'll tell me when I call. Hopefully, I'll just be able to call my ob's office. It's a large office and I don't really have a relationship with any one doctor, even the one that delivered me. I have yet to find a PCP here.
I got DS's Nystatin from the pedi, my APNO from the CNM, and the Diflucan from gen dr. (after visits/calls to no avail to same dr, to CNM, etc.) BTW, the APNO has to be compounded and is ~$65.

Ya, I was topless many days...poor neighbors. Good thing it was the summer.
If it's only on one side, maybe you're just catching it really early and it hasn't caught on the other yet? You actually don't need the Diflucan, from what I've read, if it isn't back in the ducts yet, which it may not be....if it's just contact right now. IIRC anyway

[Melbel]

I have heard that info on Gentian violet. So, it's hard to decide whether to go with that or a prescription antifungal, which I'm sure has it's own issues. So, did you take the diflucan orally and put the nipple cream on topically (of course)?

IF Nystantin has such a bad track record, why are people prescribing it instead of diflucan?

I do have some probiotics I bought for suspected milk allergy in DD, so I had it ready to go. DS and DD (both on amox), and now me, are taking it. I noticed DD's diarrhea isn't as bad after she's had some of the probiotics.

It's hard not to have my "the kids are in bed" icecream treat.


Our case has been so resistant that we have tried EVERYTHING including gentian violet, multiple rounds of Diflucan and other antifungals, grapefruit seed extract, probiotics, echinachea, garlic.... you get the idea.

Diflucan - available in generic form; pills that you take orally
Gentian Violet - I used the Jack Newman protocol; paint the nips and the baby gets treatment while nursing; baby's lips will be purple for a couple days after treatment (petroleum jelly on lips before nursing decreases staining a little; people actually asked if DD2 got a hold of a marker...)
APNO - topical ointment used after nursing; must obtain from a compounding pharmacy; our out of pocket was ony $18; it really helped to soothe the burning pain
Grapefruit seed extract - use liquid form diluted in water to wash breasts after nursing; pill form as a natural antifungal
Nystatin - swab liquid in the baby's mouth; IIRC it is less effective because yeast is becoming resistant and the fact that it is in a sugary solution. It is easier on the baby and used to be more effective so it is still the first line prescription. There is a pill form of Nystatin as well, but not the most common treatment.
Probiotics - In addition to helping with the thrush, I have found that the probiotics help keep DD2 more regular for GI issues

Don't get me started on ice cream, my favorite treat! It definitely sounds like you are catching it early. Hopefully, it will clear up quickly for you. In other good news, DD2 will be 9 months old tomorrow, and we are still solely BF through all the thrush!

[DrSally]

OK, so the peds office nurse was annoying. She refused to prescribe anything b/c "she doesn't have it". She said if there aren't any white patches, she doesn't have it. That's contrary to what Dr. Newman, Kellymom and Dr. Sears say. I mean, I'm not prone to thrush and I haven't had it in 3 years of nursing, except, now when she's on antibiotics.

My next call is to the ob. Is it possible that I can get treated only, or will that just be useless?

[Melbel]

My next call is to the ob. Is it possible that I can get treated only, or will that just be useless?

You really need to treat both. Gentian violet would treat both you and baby if you decide to go that route. You may also consider setting an appt. with the pediatrician and bring your research with you.

[DrSally]

Well, the OB office said that they depend on a dx of thrush in the baby first, so it's like a catch-22. They are going to call me back. The peds office nurse was rather nasty in insisting that the baby doesn't have it unless there are white patches and the WILL NOT treat unless they see white patches. The OB office nurse said she will talk to the doctor and call me back. She said they have a nipple cream they prescribe. From what I've been reading, oral diflucan is the most effective...

I might end up going the gentian violet route if no one is going to prescribe for me.

The pain seems less today, but maybe I'm getting used to it. It's radiating to my armpit at times after feeding too.

[Melbel]

I have also been so frustrated with thrush treatment at times. As another suggestion, see if you can fax over the resource materials, highlighting the sections stating the baby may or may not have white patches in mouth. FWIW, DD2 NEVER had white patches in her mouth.

[srhs]

Well, the OB office said that they depend on a dx of thrush in the baby first, so it's like a catch-22. They are going to call me back. The peds office nurse was rather nasty in insisting that the baby doesn't have it unless there are white patches and the WILL NOT treat unless they see white patches. The OB office nurse said she will talk to the doctor and call me back. She said they have a nipple cream they prescribe. From what I've been reading, oral diflucan is the most effective...
...I might end up going the gentian violet route if no one is going to prescribe for me.

This is so so so frustrating, I know. :hug:
The nipple cream is likely the APNO, and according to Newman's stuff, it really might be all you need. It contains an antifungal. The Diflucan really is the last step for cases resistant to other treatments, from what I've read. I would definitely accept the Rx for the APNO.
Again, JMHO from everything I read, but if the APNO kicks it for you, it actually might be enough because DC's can clear up on own in 1-2 weeks. So, if you aren't reinfecting her and you're both beefing up on probiotics, it could work.

[DrSally]

I hope the ob will give me the nipple cream. I just called around and have not been able to find gentian violet. Has anyone had any luck with grapefruit seed extract, either liquid (on nipples) or pill for (ingested)? It seems pretty safe and might work for us b/c our case seems pretty mild right now.

ETA: I just found my health food store has the grapefruit seed extract--both pill and liquid. Not sure which is better, but I'm going to go after DD wakes up. Hopefully I will get the APNO too. Wondering also...I read Dr. NEwman's protocal and he says to use probiotics for baby 2x a day, but only for 2 days. Wondering why only 2 days. I've been giving it for about 4-5 days. I thought it was pretty inocous and not likely to cause any harm, even if given every day?

[DrSally]

This is so so so frustrating, I know. :hug:
The nipple cream is likely the APNO, and according to Newman's stuff, it really might be all you need. It contains an antifungal. The Diflucan really is the last step for cases resistant to other treatments, from what I've read. I would definitely accept the Rx for the APNO.
Again, JMHO from everything I read, but if the APNO kicks it for you, it actually might be enough because DC's can clear up on own in 1-2 weeks. So, if you aren't reinfecting her and you're both beefing up on probiotics, it could work.

Hmm, I could see that working. I'm glad to hear babies can clear it on their own. I'm just counting the days until she's done with the antibiotic (Thurs). I've also been putting diluted vinegar solution on my nipples, as per Dr. SEars' website.

[DrSally]

Well, I never heard from the peds office. The ob office that I also called first thing in the morning, I had to call back 3 times. Finally at the end of the day, I called the after hours number and they got on my case b/c it wasn't an emergency. I said, "look, I've been waiting for treatment since Sat morning, and called first thing this morning and was told I would get a call back in 1-1.5 hours, called back 3 times and now the office is closed. They called the office and someone there was able to talk to me and call the APNO into the pharmacy. The closest compounding pharmacy is about 20 min away and I was just in the area b/c I was at the natural food store to get the grapefruit seed extract. She said I could get tonight it if I could get there by 6pm. Um, no, I'm home alone and just got in for the night for supper and bedtime. Oh, well, I'll be happy to get it tomorrow.

[Melbel]

:hug5: Hang in there mama.