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Old 03-14-2003, 01:08 PM - Thread Starter
 
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Okay, I've come through latch on problems and cracking and all kinds of nonsense, and just yesterday was congratulating myself that nursing was finally comfortable. This morning my left nipple was superpainful again! I have cracks there, again! AND, ds is pulling off the left side (without unlatching, thanks) and crying! Now the whole left breast hurts, as it did briefly a week or so ago.

Yes, I'm calling LLL and the lactation consultant today. In the meantime, any guesses why I'm going in cycles of nursing problems this way? My son seems to be latching on correctly, at least in daytime nursing when I can monitor him--mouth is wide, tongue down and forward, lip flared out, nipple closer to upper than lower lip. Could I have an infection on the left side that is changing the taste of the milk, and just not know it?

Divorced mom of one awesome boy born 2-3-2003.
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Old 03-14-2003, 06:41 PM
 
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It could be a few things. He may have an ear infection on that side which would case him to not want to nurse or nurse differently on that side.

I went through cycles also, I think everyone does. It was easy for a little while and then we would go through something: colic, thrush, mastitis, breast infection. We seemed to go in waves. Until ds was 9 mo.s then it was awesome and pure joy, other than the short bout of teething but truly it wasn't bad. It took a few very light nips and my response to solve that. Then by the time he was a year (I had only planned to nurse for year b/c I thought I would be lucky just to make it that far) that I discovered I didn't want to give it up and ds sure didn't. I wish you the best of luck and LLL will be a GREAT help. That's when I started to go to the meetings and it was such a help just to meet other moms who could relate.
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Old 03-14-2003, 07:25 PM
 
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How is it going now? Were you able to get in contact with your LLL leader and LC? Thinking about you.
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Old 03-14-2003, 08:29 PM - Thread Starter
 
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I phoned the LLL leader and she was great. I'm going to try to go to a LLL meeting on Tuesday if I can swing it. After we had spoken for some time, she said she thought I could have thrush. This makes sense, because:

1) I had antibiotics during DS's birth
2) We had latch problems earlier that traumatized the nipple tissue and could have made thrush possible
3) I have had some thrush symptoms, though no white spots visible in baby's mouth or on my nipple

Also one symptom of thrush is problems with nursing that hadn't been there before--for me they were problems that went away and came back!

The LLL leader said to ask for a prescription for "all purpose nipple cream". I had read the article by Dr. Jack Newman that describes this cream. She also said I could rinse my nipples in vinegar and water after nursing and could put acidophilus on my nipples.

When I phoned the midwife she seemed doubtful that I had thrush (why? she had suggested that I should eat yogurt to prevent it!) and said I should just switch the nursing positions to fix the cracking. I knew she had a thing about not always nursing in the same position, so that wasn't surprising. Anyway, she decided to prescribe Diflucan (flucanazole) and not the nipple cream.

I looked it up online and it seems like it should be safe for me to nurse after taking it. The manufacturer says not to do it, but they also prescribe larger amounts of the drug for babies than will be secreted in the breast milk. (I tried to get information from the pharmacist but she was totally clueless. She even resisted giving me the package insert for the drug!) The dose is one pill this week and one next week.

So I just took it and now I can't un-take it. I hope it was the right thing. I have nursed DS three more times today, only once on the left side (I'm going to get lopsided!) and he didn't pull off the left side the second time, just nursed and was okay.

Divorced mom of one awesome boy born 2-3-2003.
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Old 03-15-2003, 01:26 AM
 
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You may want to go to the top of the page and do a search for "thrush." If your pain doesn't go away in a day or 2, there are other home remedy type things to do to speed recovery. good luck!
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Old 03-15-2003, 01:54 AM
 
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Diflucan is safe while nursing. In fact, although the drug doesn't get into your breastmilk in amounts that would be therapeutic to treat thrush in your baby, if it has an anti-yeast effect in your baby that's a good thing, because if you have yeast then both of you have it.

Several points, though: first, your prescription of Diflucan is nowhere near enough to get rid of thrush if that's what you have. The one-pill dosage is for vaginal yeast infections. For thrush, you need to take 400 mg for the first dose (loading) and then 100 mg twice a day for 10 days, with a second course if necessary.

See Dr. Newman on Diflucan

Second, there is no reason not to use the nipple cream as a first approach, especially in conjunction with other treatments like grapefruit seed extract, vinegar rinses, dietary changes, etc. Here are some yeast treatment plans:

Dr. Newman on yeast

Pat Gima's yeast treatment plan

Third, if you have yeast your baby needs to be treated, too. Otherwise you will just pass it back and forth. (Same principle as if you were having recurring vaginal yeast infections, your dh would need to be treated as well). What most peds prescribe for babies is Nystatin, which is pretty ineffective. You may need to go to gentian violet, or grapefruit seed extract, or Diflucan, whatever works.

Dr. Gordon on GSE

Dr. Newman on Gentian Violet

Taking probiotics (especially enteric coated capsules that will get the good bacteria to your gut without getting killed by stomach acid) is really helpful. There's also probiotics for babies, such as Country Life's Baby Maxi Dophilus which comes in powder form that you can put in a bottle of expressed breastmilk, or just rub it in your baby's mouth.

If it is yeast - good luck, and do what you need to do to get rid of it; those little yeasty buggers are persistent, and painful!

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Old 03-15-2003, 08:39 PM
 
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capt optimism I should have thought of thrush! You're probably right. That's the only time I cracked with ds. We got it at 7 mo.s. Best to get on top of it now. Something else that works is to make a paste of baking soda and water and let it dry on your nipples. Ds never had white spots in his mouth but I'm sure he had it as we passed it back and forth for months and months. Be sure to wash your bras in hot water and any clothes that may be touching your breasts. I actually took acidophilus too and you can dilute it and put it in the baby's mouth as well, or even straight (check on that though). Good luck!
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Old 03-15-2003, 09:01 PM
 
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Hi there we are actually battling thrush here too. I had it for 5mos with ds1 we'll see how long it takes to get it cleared this time. I do vinegar rinses after every nursing, ds's never exhibited any symptoms either , so some children may and some may not. I'm thinking of moving on to the gentian violet now, we have been using nystatin and taking acidophilous. I also use tea tree oil in the wash of my bras to help kill those yeasties. Hope you are feeling better soon.
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Old 03-15-2003, 09:14 PM
 
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Also, I don't know if you're pumping and feeding ebm by bottle (are you working outside the home at all?) but if so, then all pump and bottle parts that are used need to be boiled every day, and don't freeze any milk that you pump while you have yeast - the freezing won't kill the yeast. (It's OK to feed the pumped EBM while you're treating the yeast, just don't save any because you may re-infect if you feed it after you've gotten rid of the yeast).

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Old 03-16-2003, 10:06 PM - Thread Starter
 
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I'm still unsure if I have thrush. I left a call for the pediatrician, and the doctor who was on call said they never culture the baby's mouth for thrush, they only treat it when they see white spots on the tongue. She gave me the name of yet another LLC.

I read every article by Dr. Jack Newman and all the LLLI website articles on thrush. I have gone back and forth about it. If this is thrush, why does it hurt only on one side? But, if it is, that would explain a lot of the baby's behavior.

The lactation consultant who helped me most with a home visit called back. She admitted that thrush is hard to diagnose and suggested that I come into the office to get checked out by her supervisor on Tuesday.

Did you ever notice that everyone who ever nursed or worked with nursing moms has a different idee fixe about what will help the most? Change positions! Dry the nipples! Lie down! Sit up! Warm compresses! Ice cubes!

On the plus side, since my left breast has hurt so much, I've found out I can pump five oz. from it in 15 minutes. Could bode well for me when I go back to work in 2 weeks...

Divorced mom of one awesome boy born 2-3-2003.
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Old 03-16-2003, 10:58 PM
 
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If one of your breasts cracked and the other didn't, you could easily get yeast in one and not the other from what I understand, or the overgrowth could be a lot worse in one and not the other. Evidently the serum that oozes out when the skin is broken on the nipple causes the yeastie beasties to mutate into their evil form.....

Do you have sharp shooting or stabbing pains deep in the breast, like someone's stabbing you with an ice pick? Or intense itching on the breast? Those were my symptoms.

You could try doing the dietary changes, grapefruit seed extract, probiotics, garlic capsules, vinegar rinses, etc. and see if those help at all - if so, then maybe that's a better clue that yeast is causing the problems, if not, then no harm no foul.

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Old 03-17-2003, 12:46 AM - Thread Starter
 
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I have some of the symptoms but they could also be symptoms of other things. That's the problem. If it is thrush, then I know what to do, and that would be great. But then I'll have to get rid of all the milk I've already frozen, right? and there's a lot. I'd hate to do that and find out that I don't have thrush.

I'm still pumping but it's going in the fridge for now. Daddy and baby have just started practicing their bottle feeding anyway, for when I go back to work. I still have a good supply from both breasts--in fact today I felt like I had to pump the left because it hurt from being too full. We've started boiling all the pumping and bottle parts. Ick.

I'm hoping that Tuesday I can go to both the lactation consultant and the LLL group, and get a conclusive answer.

What is "serum"?

Divorced mom of one awesome boy born 2-3-2003.
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Old 03-17-2003, 01:28 PM - Thread Starter
 
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okay, I spoke with the lactation consultant the pediatrician recommended, and she persuaded me that if this isn't thrush, I still have to treat it like thrush--topically: liquid nystatin for baby and all-purpose-nipple-ointment (apno) for me. so once i get my scripts, I'm going to boil my bras.:
Not sure what to do about the EBM in the freezer.

But perhaps now I'll stop having that annoying and painful vasoconstrction in the nipples...

thanks for all your support!

Divorced mom of one awesome boy born 2-3-2003.
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Old 03-17-2003, 01:41 PM
 
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I think serum is the clear fluid that oozes when you have a wound....the dictionary says it's what's left in blood once you take out the cells, etc.

Let me just warn you that Nystatin isn't particularly effective, and it's a PITA to use. Not saying don't use it, just that it may take more than that to get rid of thrush. Also, if you have yeast in your milk ducts, the ointment isn't going to cut it. Definitely check out the Pat Gima yeast treatment page I linked before.

I don't know how much of a freezer stash you've built up but with any luck you won't need to use much of it. I found that I could generally pump enough one day for my baby to drink the next. One thing you might think about (although I know this is heresy for many) is IF you need to delve into your old freezer stash, boil the milk. Yes, you'll kill the antibodies, but your baby will get lots and lots of antibodies from the milk straight from the source as well as the freshly pumped milk, and you'll be able to avoid formula. Breastmilk that gets donated to milk banks gets pasteurized but is still considered much much better than formula.

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Old 03-17-2003, 01:55 PM
 
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Also, if you've dated your frozen breastmilk, as you should, you should be able to approximate which milk is pre- and which is post-yeast infection.

Definitely do all the home remedy recs from the great links provided. You don't want to have this to worry about, to add to the going back to work issuee. Good Luck!

(for anyone esle lurking here that is a new mom and getting scared, not all moms get thrush! I never did. In fact, I had antibiotics once or twice while nursing and got a vag yeast once, but not in the breasts. Go figure!)
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Old 03-22-2003, 10:50 PM
 
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I had a crack on one side where the thrush started uncer my left nipple for about a month before I knew that it was thrush and it spread to the other side. Even though there were no spots in baby's mouth the dr.s treated him for it. I had a devil of a time of it though, I never really got rid of it but it did lessen considerably so that it didn't hurt. Let us know how it goes. Definitely treat both of you though or else you'll just keep passing it back and forth.
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