thrush once it's gone into the breast? EDIT WITH UPDATE & Q IN ORIGIONAL POST

[FondestBianca]

Ds got thrush a couple week ago and I didn't finally start putting the pieces of the puzzle together and figureing out thats what was going on until his diaper rash began and my own pain set in. I started treating my nipples with gv a few days ago and haven't seen improvement yet. Ds diaper rash looks horribly painful (it's on his boy parts not his bottom. cream isn't helping as of yet). Been treating ds oral thrush with 2nd hand gv from BFing. I have the oral thrush as well from slobbery baby kisses and sharing spoons... sore throat, very small sores in the inside of my lips but, haven't resorted to turning my own mouth purple just yet.

Heres the issue that inspired my thread. My left nipple is suffering rather baddly. Feedings are extremely painful and have been for several days now. There is now an open wound near the tip of my nipple, Feedings are an inch away from unbareable ATM. Now it seems that it has crept inside my breast. When ds eats from that side I can feel pain following the milk ducts all the way to my armpit. The pain isn't horrible yet but, it's bad. The left side of my left breast is a bit hard (the whole side. no specific spots or lumps) and it has the same stinging feeling that my nipples have had since the thrush set in.

Do I need to use something besides the gv & some neosporin on myself for the internal problem? How long does it usually take to see improvement? I don't have any kind of medical coverage for myself (ds does so he can get any kind of medication he may need for his thrush) so I'm pretty limited. I can't afford to see a doc.

ETA with update and question: ds's diaper rash is gone with help of medicated perscription cream. Some oral thrush remains. Right breast has cleared up enough that there is no pain during feedings. Left breast and nipple got better for a couple days but, now are in more pain than ever. The entire breast hurts, it feels more solid and lumpy inside, veins (especially below the nipple) are constantly bulging, nipple has visibly infected laseration (small but very painful) and nipple is still bright red, and nursing is soooooo painful that I barely manage to get through a feeding without tears and scaring ds with my unavoidable yelping when he latches.

so what do I do now? What should I be using on myself at this point. Is the GV and medicated cream enough? Is it going to work eventually? Do I now have an internal infection? Should I be worried about more than how much pain I'm in?

[paulamc]

Sorry mama, that sounds rough! Have you seen Jack Newman's protocol for treating candida/ thrush?

http://www.nbci.ca/index.php?view=ar...tent&Itemid=17

For pain inside the breast, he recommends as a first line treatment oral grapefruit seed extract and/ or probiotics. If that doesn't work, you might need to find a way to get fluconazole/ diflucan. I'm using all of these at the moment, and I've just about licked it (for the second time )

For my nipples, I've found that the topical grapefruit seed extract (diluted with water) is helpful. Are you using any topical anti-fungal aside from the gentian violet, such as a miconazole cream? You should be using something after every feed and the gentian violet once a day for 7 days. By the way, Jack Newman says that if the GV is not helping after 4 days, it probably isn't going to help. It might not be yeast in this case.

In your shoes, I'd make myself an OTC all purpose nipple ointment - that is, if I couldn't get a prescription for Jack Newman's APNO available from compounding pharmacies. I'd include the following in equal quantities.

monistat cream (or something similar with miconazole)
hydracortisone OINTMENT or something like that (not cream)
polysporin, or neosporin or a similar antibiotic OINTMENT (not cream)

The antibiotic is included because though candida is a fungal infection, bacteria can invade the nipples through breaks in the skin which commonly occur when you have thrush.

To summarize - I suggest the following:

after each feeding apply:
grapefruitseed extract solution (10 drops to 1 ounce of water)
when that dries, apply some of the above OTC nipple ointment

once a day:
gentian violet

for deep breast pain - three times a day:
oral grapefruit seed extract capsule
acidophilus / probiotics

And eat lots of yogurt! Also, add vinegar to the rinse cycle of your wash when washing bras, nursing pads, and anything that comes into contact with your milk or breasts. Wash this stuff in hot water. Sterilize artificial nipples and breast pump parts. Use towels only once then throw into the wash. (I don't actually do this, but it was the recommendation from my lactation consultant)

Good luck. I've been there and know how horrible this is. If you can't get rid of it this way, you can consider writing Jack Newman an e-mail. He might have an idea of how you can get some fluconazole without a prescription.

[FondestBianca]

paulamc: thank you very much for the response! Lots of useful information. Tonight they are looking a little less red so maybe I'm making some progress. Got a cream for ds that I was told to use on myself as well so I'm going to give that a go tomorrow along with some grapefruit as you directed!

[FondestBianca]

update in origional post

[paulamc]

What does the deep breast pain feel like?

The lumpiness and pain in whole breast make me wonder if you might have a plugged duct. Have you had that before to know what it feels like? Are parts of the breast hard (where the milk might be backing up) and does that part hurt more? Has your supply taken a dip at all?

Given the breaks in the skin, it's possible you have a bacterial infection in addition to the yeast. Did you try to make an OTC all purpose nipple ointment with three ingredients like I suggested, including an antibiotic? I really recommend this because it's possible you have several things going on. The steroidal element can help with inflammation and healing. Since you have a prescription cream, you could just make a second ointment with the polysporin+hydrocortisone and apply both - or you could mix the three together.

What medicated cream are you using? I ask because some of them are no longer effective as candida has become resistant to the antifungal agent - though given the partial improvement this probably isn't so in your case. Nystatin was useless in my case. But if your cream has miconazole in it, it's probably okay.

Regarding the GV, how long did you use it? I don't think you should use it more than 7 days in a row. You can repeat the treatment later after a break, I believe, but not right away.

Is there an experienced lactation consultant you could go see? While they can't prescribe anything, they may be able to give you an idea what the remaining problems are, and direct you to a doctor who knows how to treat thrush.

For the pain, I recommend you take a heavy dose of ibuprofen. The dermatologist I saw takes a particular interest in yeast infections/ thrush since he also has a pediatric specialization. He prescribed a strong pain medication for me and boy did it help!

I do think you need to worry about more than the pain. It's important that you get this cleared up if you want to continue your nursing relationship. For some women, pain can affect supply because they don't let down as well when they're in pain. In addition, it's possible you may subconsciously delay nursing because it's so painful - this could potentially affect your babe's nutrition and your supply. And aside from all that, breast feeding is such a joyful experience when it's going well, and you want to be able to experience that joy fully!!!

[FondestBianca]

Originally Posted by paulamc

What does the deep breast pain feel like?

The lumpiness and pain in whole breast make me wonder if you might have a plugged duct. Have you had that before to know what it feels like? Are parts of the breast hard (where the milk might be backing up) and does that part hurt more? Has your supply taken a dip at all?

Given the breaks in the skin, it's possible you have a bacterial infection in addition to the yeast. Did you try to make an OTC all purpose nipple ointment with three ingredients like I suggested, including an antibiotic? I really recommend this because it's possible you have several things going on. The steroidal element can help with inflammation and healing. Since you have a prescription cream, you could just make a second ointment with the polysporin+hydrocortisone and apply both - or you could mix the three together.

What medicated cream are you using? I ask because some of them are no longer effective as candida has become resistant to the antifungal agent - though given the partial improvement this probably isn't so in your case. Nystatin was useless in my case. But if your cream has miconazole in it, it's probably okay.

Regarding the GV, how long did you use it? I don't think you should use it more than 7 days in a row. You can repeat the treatment later after a break, I believe, but not right away.

Is there an experienced lactation consultant you could go see? While they can't prescribe anything, they may be able to give you an idea what the remaining problems are, and direct you to a doctor who knows how to treat thrush.

For the pain, I recommend you take a heavy dose of ibuprofen. The dermatologist I saw takes a particular interest in yeast infections/ thrush since he also has a pediatric specialization. He prescribed a strong pain medication for me and boy did it help!

I do think you need to worry about more than the pain. It's important that you get this cleared up if you want to continue your nursing relationship. For some women, pain can affect supply because they don't let down as well when they're in pain. In addition, it's possible you may subconsciously delay nursing because it's so painful - this could potentially affect your babe's nutrition and your supply. And aside from all that, breast feeding is such a joyful experience when it's going well, and you want to be able to experience that joy fully!!!

i got some grapefruit seed extract (already had the other ingredient) and applied. I used the gv for about 5 days... it seemed much better and I stopped using it... perhaps too soon. I'm not sure what kind of cream ds had perscribed off the top of my head. I'd check but it's in his room and I finally got him down for a nap so theres no way I'm opening that door right now!

I've had a plugged duct before. This doesn't feel like that. The pain I have is tenderness all over but mainly one side, along with a shock sort of feeling while ds is eating, AND and pain that could almost be described like a headache... only it's in my breast. A throbbing sort of stab of pain that rediates out. The open laseration looks worse todya despite applying neosporin 3 times yesterday. It looks deeper and is gaping open now and swollen around it. The fullness/lumpiness isn't super hard like with a plugged duct. It more of an allover swelling inside that stays consistant with glands but isn't isolated to just one or two like a plugged duct.

I've been careful not to ingore the left side when feeding time comes around. I'm trying different positioning to at least avoid his teeth rubbing directly on the open sore. It's really difficult because ds is going through some sort of stage where he often rejects the breast and constantly pops on and off unless sleepy or having just woken up from sleep and overly hungry. No matter how much I withhold solids he still seems angry at the breast quite often. It may be from lingering oral thrush?? There is still a small amount of white film remaining on the insides of his cheeks. Going to reintroduce the GV for that today.

My supply seems to be ok. The left side takes longer to letdown however... almost like it isn't able to come out as fast thus delaying letdown. The right side is totally painless as of today. The tip of the nipple is perhaps a TINY bit red but, aside from that, no symptoms of thrush or infection on that side.

[paulamc]

I'm so glad at least one side is painless! That was my case as well, for a long time, and it sure did help. But even so, I know this sucks. Hang in there mama - you're doing a great job in a difficult situation!

The stabbing pain does sound like yeast in the breast.

For the topical issues, I would continue the topical grapefruitseed extract solution (10 to 12 drops per ounce of water) after every feeding, followed by an antifungal cream/ ointment - and maybe a combination hydracortisone/neosporin ointment a few times a day. It seems like the hydracortisone element can help prevent the other agents from irritating and drying your skin. Which reminds me, be careful not to increase the concentration of the grapefruitseed extract too much. I did this, thinking it might be more effective, and it caused a lot of pain.

If there's ANY way you can get hold of some of Jack Newman's APNO, this would be great. It's been SO helpful for me. More effective than the OTC one I put together. He will send you a prescription, but you need a doctor in the US to cosign or prescribe it if you're here. You have to get it from a compounding pharmacy. Do you have any friends in Ontario who could get it filled for you using his prescription? He will e-mail a prescription and such a friend could just fill in their name, get it filled then mail it to you!

I'll be interested to know what cream you have, once your babe awakes. If it's nystatin (and it very well may be), I would definitely recommend you try something with miconazole instead, such as monistat cream or lotrimin because apparently the nystatin only works in about half of cases as yeast has become resistant to it. And another course of the GV maybe, as it seems to have helped before, right? Did you read Jack Newman's' protocol? I don't recall if he says how frequently you can do it. You could write him an e-mail with that question if it doesn't say. He's good about replying.

I just noticed that your son is 8 months old. In this case, since your supply seems well established, I think I would try nursing mainly on the right side for a couple of days to allow the laceration on the left to heal. Could you pump on the left and give him the extra milk in a bottle or cup?

For the deep breast pain you definitely need something else, as I understand it. Jack Newman recommends starting with oral grapefruitseed extract (it comes in pills and you take three per day) and probiotics. They aren't cheap, but they're cheaper I suppose than fluconazole/ diflucan from a doctor would be since you said you don't have insurance. I really don't know how much success people have had treating with oral grapefruitseed extract + probiotics only but I would definitely try. I did this in combination with the fluconazole. I know you already have the liquid - you can take this orally (see Jack Newman's protocol) but note he says it's not as effective, and it tastes bad.

The other thing to note is that you really need to keep treating your little one to avoid reinfection, especially since he is symptomatic. Of course, the GV can help but you only take that a few days. Did the doctor only prescribe a cream, and nothing for his mouth? My family practice doctor prescribed nystatin cream and a nystatin oral solution which we used to swab his mouth before feedings. The nystatin seemed to be useless so I then switched to an oral suspension of fluconazole (from a different doc) to treat his mouth. If you don't have anything besides the GV for your DS, you could put a little probiotic powder on his tongue and cheeks before feeding - or yogurt maybe.

Good luck and keep us posted!

[jecombs]

I had a horrible thrush infection that went on and on for about 3 mo. It sounds like you really need to get Diflucan for yourself and DS. Maybe you could ask DS's ped if he/she felt comfortable prescribing it for you. That would at least save you the cost of a dr. visit. Dr. Newman's protocol recommends continuing with the Diflucan until you have been symptom-free for 5 days. For me and my DD, this meant taking a 2 week course of it. If you can't afford the medication, it is possible that the manufactorer might help you pay for it.

Okay, I just did a search and Pfizer makes Diflucan and they do offer prescription assistance for it. Here's a link for the programs and applications: http://www.pfizerhelpfulanswers.com/...indresult.aspx

Good luck getting rid of the thrush! Make sure you are sterilizing every thing that comes in contact with DS's mouth, your nips, and your breasts (including bras). That will prevent re-infection from happening.