More questions about thrush - please help, feel like giving up! (Sorry, long post)

[Cattia]

In went to the doctor this morning as I feel that my thrush is getting worse rather than better. These are the symptoms I have:

Really painful latch on which was not painful before
Painful letdown reflex - again, not painful before
Sore and sensitive nipples - not just during feeds
Shooting pains in breast when feeding
Small white dots around areola (very small, like pin prick size)
Worse on one side than the other

The doctor (a man, needless to say) said that it can't be thrush that is causing this as thrush does not cause pain.

I may not be a doctor but I do know that pain is THE main symptom of thrush, I also had a MW and a health visitor tell me that my sympoms were very likley to be caused by thrush. I managed to persuade the doctor to give me some nystatin drops for Abigail's mouth, and I am already using Nystaform on my nipples. However if I have these shooting pains in my breasts, then surely the thrush must be in the ducts and not just the nipples?

I have read that flucanazole can be used to treat oral thrush. I know this is available over the counter for vaginal thrush, but is it the same thing? All the literature on oral canesten says you should not use it whilst BF so is it different?

I also read that Daktarin is meant to be way better than Nystatin for treating thrush. I have some Daktarin oral gel, can I use it on my nipples or in LO's mouth, and if so, is the one they prescribe the same one as you get OTC? (Daktarin 2%).

I have made another appointment for tomorrow with a female doctor, but I am afraid I am just going to get the same treatment. I am going to print off some info about thrush from La Leche league so at least I am armed with something. I just feel so down about this as if I can't get it treated properly I know it won't go away and then I will have to give up BF which makes me so sad, I feel like just crying.

I am sorry if this is long but I just don't know what to do for the best. Advice on any of the above would really help. Thanks for reading.

 

[candyfloss]

Big hugs!

Def sounds like thrush to me. Also print out the leaflet from the breastfeeding network site...
www.breastfeedingnetwork.org.uk/pdfs/BfN_Thrush_leaflet_Feb_2009.pdf

The oral treatment is the same (fluconazole) as vaginal thrush but you need it in a much higher dose if its in your ducts. Its not licensed for use in BF mothers but if the Dr agrees (and you insist its what you want, are aware its not licensed etc) you can still get it on prescription. The amount that comes through in your milk is about 10% of the strength thats ok for babies to have so won't harm (or treat) LO.

I used Nystatin on W's mouth (apply with your little finger to cheeks, tongue etc) and thrush cream on my nipples as well as the fluconazole orally to treat mine - really do need it sorting by treating all three areas. Also put cream on LOs bum as the thrush can pass through their guts and cause fungal nappy rash. And take painkillers regularly!

I had to see about 3 different people before I got the correct dosage, really do keep going and go armed with the info.

Let us know how it goes!

 

[Cattia]

Thanks Candyfloss. I am so fed up of this and so frustrated that doctors don't seem to know a thing about it! What is the dose of fluconazole you need? I just want to get rid of this so that I can start enjoying BFing LO. We were just getting the hang of it and now this! I wonder if I got it because I had cracked nipples at the start and maybe it got in trhough the cracks?

 

[dacosta]

hi cattia - (your doc sounds like a right idiot; can your MW not back you up by calling him?) all sorts of things can cause thrush but yes cracked and sore nipples at the start can cause it especially if you're using breast pads as the nipples stay moist and warm - perfect for the bacteria. make sure to change the pads whenever they feel moist. i was plastering on lanolin at the beginning as well and i'm not sure that helped but i couldn't bare the thought of not using lanolin. stress can cause it, as can iron-deficiency anaemia. the symptoms are often the same as other problems as well, which makes diagnosing it really hard. mine was missed for two weeks until i started researching it myself. there's still a tiny amount of doubt in me that it is actually thrush as i dont get very bad deep boob pain. but it sounds as though this is your main symptom.

i did get pain in the area you press to express, just behind the nipple but for me it wasnt that bad comparing it to the nipple pain so the MW didn't think it was thrush for me initially

i was prescribed nystatin for lo and applied a little with my finger after every single feed and it's working as her very white tongue is clearing up; so stick with that and hopefully it'll work for your lo.

my dose of fluconazole was a big first doze 150mg x 2 and then 50mg doses twice a day for 9 days. it takes about 3 days to start working and my right nipple starting feeling much better yesterday - 3 days ish - my left is still bad but its always been very badly cracked so i suspect itll take longer to heal.

3 days seems like forever when you're in pain but stick with it. at the worst, if it doesn't work you know it's not thrush and can rule that out.

 

[Cattia]

Thank you Dacosta. Looks like I am going to have to do battle with the doctor tomorrow then! I am going to try my hardest to get Fluconazole. At least now I know that it is the same as the OTC version, I can always buy it and then split the capsules (they are 150mg for vaginal thrush) and just use them in smaller doses but more regularly. The problem with this is that a) the dose won't be as accurate as it should be b) It will cost me a fortune since vaginal thrush tablets are about a fiver each! I really hope I can crack this, I am convinced thrush is the culprit. I have also bought high dose acidopholus today so we'll see if that helps as well, and I have read that vinegar washes of the nipples after feeding helps too. I am determined to beat this and keep going with BF!

 

[candyfloss]

The breastfeeding network recommends an initial loading dose of 150-300mg, then 50-100mg twice a day for at least ten days.....

I would keep badgering the Drs, I think it would be such a shame if you were forced to stop BF because you didn't get a simple treatment. I had thrush for about 4/5 weeks and cried everytime I had to feed W so I know your pain!!

Keep going and keep going to the Drs! Take the info with you, thats what I ended up doing.

 

[candyfloss]

The breastfeeding network recommends an initial loading dose of 150-300mg, then 50-100mg twice a day for at least ten days.....

I would keep badgering the Drs, I think it would be such a shame if you were forced to stop BF because you didn't get a simple treatment. I had thrush for about 4/5 weeks and cried everytime I had to feed W so I know your pain!!

Keep going and keep going to the Drs! Take the info with you, thats what I ended up doing.

 

[lfernie]

I was given nyastin for lo and dakarin (sp) oral for my nips!I think it's probably good on ur nips for lo aswell as it means that at some point it will go in their mouths but I was told not to gv directly to lo As it's so thick and they can choke but that was when he was 5 weeks old so maybe it's ok for older babies. And yeah ur doctor sounds like he's obv never breastfed! No pain...such a typical man thing to say! x

 

[Cattia]

Well, slightly more success today with a different doctor, but still not great. She says carry on with the topical treatment for the rest of the week and if it is still not better then she might rescribe something oral, however she told me that if she gives me any oral medication I will have to stop breastfeeding *sigh*
I have done my research into fluconazole (plus there are lots of you on here who have taken it) so I know that this is NOT the case. Why must we work so hard to educate these docotrs? I can't tell you how tempted I am to just buy OTC fluconazole for oral thrush and self medicate. I could split the 150mg capsules into 3 to get the 50mg daily dose.