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Austin Babies
mrs.wildman
member
Have you ever dealt with Thrush?
mrs.wildman
member
I suspect DD has it, and possibly myself too in that we BF and I've noticed some sensitivity while feeding her. We've both been on antibiotics on and off for the last month, so it's not too surprising. DD has a bad blotchy diaper rash that won't go away. It doesn't seem to bother her too much, but it looks pretty bad. So far I haven't noticed any white in her mouth, but she doesn't really let me get in there to check.
If you've dealt with this before, What form of treatment worked for you?
I googled options and one that popped up repeatedly was Grapefruit Seed Extract, which I just happened to have at home so started that last night. I have yet to see any improvement though, so considering starting Lotramin AF today.
We have her 6-month well check next week, so I figured between now and then I might as well try alternative treatment options before I rush to see her ped. about this. Or should I be rushing into the ped? Any help y'all can offer would be greatly appreciated! TIA!
This discussion has been closed.
Re: Have you ever dealt with Thrush?
B&W Photo by Wildhouse Photography
Our Blog
i only have a minute, so i cant fix the formatting, but this handout saved my breastfeeding relationship with ruby. we had horrible thrush for several weeks, me more than her. good luck, i hope you get some relief soon.
Candida Protocol
It is important to get the best latch possible when you have sore nipples. Even if the cause of sore
nipples is Candida, improving the latch can decrease the pain. With the ?ideal? latch, the baby covers more of
the areola (brown or darker part of the breast) with his lower lip than the upper lip. Note also that the baby's
nose does not touch the breast. Note it is not always easy to change the latch of the older baby. For videos
showing how to latch on a baby, go to www.drjacknewman.com.
Diagnosing Candida albicans (yeast)
This can be difficult and mothers should not attempt to self diagnose. The pain due to Candida albicans is
often confused with pain due to poor latching, and/or pain due to vasospasm /Raynaud?s phenomenon. A
good practitioner will help you to differentiate between these conditions.
For Nipple Pain: Specific Local Treatment of the Nipple
A. APNO (All Purpose Nipple Ointment) is a compounded ointment mixed from the following
ingredients:
?
Mupirocin 2% ointment (15 grams)
?
Betamethasone 0.1% ointment (15 grams)
?
To which is added miconazole powder so that the final concentration is 2% miconazole. This
combination gives a total volume of just more than 30 grams. Clotrimazole powder (not as good as
miconazole) to a final concentration of 2% may be substituted if miconazole powder is unavailable, but
both exist (the pharmacist may have to order it in, but compounding pharmacies almost always have it on
hand). Using powder gives a better concentration of antifungal agent (miconazole or clotrimazole) and
the concentrations of the mupirocin and betamethasone remain higher. Sometimes we will add ibuprofen
powder to a final concentration of 2%.
The ointment is applied sparingly after each feeding (except the feeding if/when the mother uses gentian
violet). ?Sparingly? means that the nipple and areola will shine but you won?t be able to see the ointment. Do
not wash or wipe it off, even if the pharmacist asks you to. The APNO can be used for any cause of nipple
soreness ("all purpose nipple ointments"), not just for Candida (yeast). Use the ointment until you are pain
free for a few days and then decrease frequency over a few days until stopped. If you are not having less
pain after 3 or 4 days of use, or if you need to be using it for longer than two or three weeks to keep pain
free, get good help or advice.
If Not Getting Better?Add:
B. Gentian violet (see handout: Using Gentian Violet). Use once a day for four to seven days. If pain is gone
after four days, stop gentian violet. If better, but not gone after four days, continue for seven days. Stop
after 7 days no matter what. If not better at all at four days, stop the gentian violet, continue with the
ointment as below and seek good help. Gentian violet comes as a 1% solution in water. It also usually
dissolved in 10% alcohol, as gentian violet is not soluble in pure water. This amount of alcohol is
negligible, as the baby will only get a drop of gentian violet. Apparently some pharmacists will dissolve it
in glycerine instead of alcohol, if you wish. 2% gentian violet should not be used.
Or:
C. Grapefruit Seed Extract (GSE), active ingredient must be ?citricidal?. Should be followed by, and
used in conjunction with, the APNO (All Purpose Nipple Ointment). Apply diluted solution directly on
the nipples. It does not need to be refrigerated. It may be covered and used until solution is finished.
To dilute GSE:
?
Mix very well 5- 10 drops in 30 ml (1 ounce) of water.
?
Use cotton swab to apply on both nipples and areolas after the feeding.
?
Let dry a few seconds, and then apply ?all purpose nipple ointment?.
?
If also using Gentian Violet, do not use GSE on that particular feed but use after all other feeds.
?
Use until pain is gone and then wean down slowly over the period of at least a week.
?
If pain is not significantly improving after two to three days, increase the concentration by 5 drops per 30
ml (ounce) of water. Can continue increasing concentration until 25 drops/ 30 ml of water
?
If flaking, drying, or whiteness appears on the skin, substitute pure olive oil for APNO 1-3x/day and
decrease the concentration of the GSE drops. If the flaking does not get better, stop the GSE drops.
?
Laundry can be treated as well: add 15-20 drops in the rinse cycle of all wash loads
?
May be used in conjunction with oral GSE and Probiotics
If Not Getting Better and/or the Pain is in the Breast as Well (Need to Treat Systemically)
Add:
D. Oral GSE: Grapefruit seed extract (not grape seed extract, active ingredient must be ?citricidal?), tablets
or capsules, 250 mg (usually 2 tablets) three or four times a day orally (taken by the mother). If preferred
the liquid extract can be taken orally, 10 drops in water three times per day (though this is not as effective).
Oral GSE can be used before trying fluconazole, instead of fluconazole, or in addition to fluconazole in
resistant cases.
And/or
E. Probiotics: Acidophilus with bifidus (with FOS (fructo-oligosaccharides) is okay). The mother should
take 1-2 capsules (strength of 10 billion cells) 2-3x/day. The probiotics should be taken at least 1 hour
apart from oral GSE. Baby should be treated with Probiotics 2x/day for approximately 7 days (Mother
may wet her finger and roll it in probiotic powder (break open a capsule), and let baby suck on mother?s
finger right before a feeding).
If Still Not Getting Better at All?
Add:
F. Fluconazole: (see handout Fluconazole) If pain continues and it is sure the problem is Candida, or at least
reasonably sure, add fluconazole 400 mg loading, then 100 mg twice daily for at least two weeks, until the
mother is pain free for a week. The nipple ointment should be continued and the gentian violet can be
repeated. Fluconazole should not be used as a first line treatment. If used, fluconazole should be added to
above topical and oral treatments, not used alone. Fluconazole takes three or four days to start working,
though occasionally, in some situations, it has taken 10 days to even start working. If you have had no relief
at all with 10 days of fluconazole, it is very unlikely it will work, and you should stop taking it.
G. Other Medications: For deep breast pain, ibuprofen 400 mg every four hours may be used until
definitive treatment is working (maximum daily dose is 2400 mg/day).
Questions? Email Jack Newman at drjacknewman@sympatico.ca, or Edith Kernerman at
breastfeeding@sympatico.ca or consult: Dr. Jack Newman?s Guide to Breastfeeding (called The Ultimate
Breastfeeding Book of Answers in the USA) or our DVD, Dr. Jack Newman?s Visual Guide to Breastfeeding; or
The Latch Book and Other Keys to Breastfeeding Success; or L-eat Latch & Transfer Tool, or the GamePlan
for Protecting and Supporting Breastfeeding in the First 24 Hours of Life and Beyond. See our website at
www.drjacknewman.com. To make an appointment email breastfeeding@ccnm.edu and respond to the auto
reply or call 416-498-0002.
Handout Candida Protocol Revised: May 2008
Written and Revised by Jack Newman, MD, FRCPC 1995-2005
Revised by Edith Kernerman, IBCLC, and Jack Newman, MD, FRCPC ? 2008
This handout may be copied and distributed without further permission,
On the condition that it is not used in any context that violates
The International WHO Code on the Marketing of Breastmilk Substitutes
OK this is what my friend said:
Tell her to go to a healthfood store (Sprouts, Natural Grocer, Whole Foods, etc) and ask for a good probiotic that SHE takes orally and that the baby will get through her breast milk. I used Nature's Way Reuteri but there might be other, better ones. That is the most important thing to do right now to combat the antibiotics she has been on.
Also, she can take a few (5-10) drops of tea tree oil and mix it with a cup or so of water and use a Q-tip to swap her nipples after she nurses each time. Tea Tree Oil has anti-fungal properties.
I was also prescribed "Newman's Nipple Cream" but that has to be gotten at a compounding pharmacy. It has an antifungal agent in it and other stuff to soothe the nipples if they are burning from the yeast.
She can get a topical for the baby from the doctor but for now tell her to get Neem Cream. The stuff is amazing and will get rid of the yeast on her bottom. She can even get Neem soap and wash her bottom with it. That can also be gotten at any of the stores mentioned above.
B&W Photo by Wildhouse Photography
Y'all are all awesome
Thanks so, so much for the recs!